Effects of toFacitinib and Other Dmards on Lipid Profiles in Rheumatoid Arthritis: Implications for the Rheumatologist

• Published in: Seminars in arthritis and rheumatism Vol. 46; no. 1; pp. 71 - 80
• Main Authors: Charles-Schoeman, Christina, MD, MS, Gonzalez-Gay, Miguel A., MD, PhD, Kaplan, Irina, PhD, Boy, Mary, VMD, Geier, Jamie, PhD, Luo, Zhen, PhD, Zuckerman, Andrea, MD, Riese, Richard, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-08-2016
• Subjects: Antirheumatic Agents - administration & dosage; Antirheumatic Agents - therapeutic use; Arthritis, Rheumatoid - blood; Arthritis, Rheumatoid - drug therapy; Disease-modifying antirheumatic drugs; Humans; Janus kinase; Lipids - blood; Piperidines - administration & dosage; Piperidines - therapeutic use; Pyrimidines - administration & dosage; Pyrimidines - therapeutic use; Pyrroles - administration & dosage; Pyrroles - therapeutic use; Rheumatoid arthritis; Rheumatology; TNF inhibitors; Tofacitinib; Apo; apolipoprotein; C-reactive protein; serum amyloid A; high-density lipoprotein; free cholesterol; MPO; total cholesterol; TNF; HDL-C; major adverse cardiovascular event; MTX; tocilizumab; high-density lipoprotein cholesterol; Janus kinase; lecithin cholesterol acyltransferase; PON-1; cholesterol ester transfer protein; twice daily; rheumatoid arthritis; RA; CVD; SAA; FCR; disease-modifying antirheumatic drugs; EULAR; TNF inhibitors; LTE; FC; CRP; triglyceride; CETP; LDL-C; long-term extension; low-density lipoprotein cholesterol; LCAT; methotrexate; TCZ; European League Against Rheumatism; tofacitinib; HDL; fractional catabolic rate; LDL; MACE; BID; Disease Activity Score with 28 joint-count; disease-modifying antirheumatic drug; cardiovascular disease; DAS28; CE; DMARD; myeloperoxidase; cardiovascular; low-density lipoprotein; TC; CV; paraoxonase-1; TG; tumor necrosis factor; JAK; cholesterol ester; Disease-modifying antirheumatic drugs; Tofacitinib; Rheumatoid arthritis
• ISSN: 0049-0172; 1532-866X
• DOI: 10.1016/j.semarthrit.2016.03.004

Cardiovascular (CV) morbidity and mortality are increased in patients with active, untreated rheumatoid arthritis (RA), despite lower levels of total and low-density lipoprotein cholesterol reported in individuals with active RA compared with those without RA. Alterations in non-traditional lipid assessments, such as high-density lipoprotein (HDL) function and HDL-associated proteins, have been described in patients with active RA, including elevated HDL-associated serum amyloid A and decreased paraoxonase-1 activity. We review changes in both traditional lipoprotein concentrations and non-traditional lipoprotein assessments in multiple studies of treatment with disease-modifying antirheumatic drugs (DMARDs), including non-biologic and biologic DMARDs and tofacitinib. In addition, data from a recently published clinical trial with tofacitinib that describe a potential mechanism for suppression of cholesterol levels in active RA patients are reviewed. Finally, CV event data from various studies of DMARDs are presented, and the current management of RA patients with regard to the CV risk is reviewed.