RESUMEN
Objective To investigate the effect of Hydroxychloroquine plus Leflunomide on the lipid profile and disease activity index in patients with rheumatoid arthritis (RA).Methods A total of 140 elderly patients with RA who met the American College of Rheumatology (ACR) criteria were treated with Hydroxychloroquine (Group A,n =70) or leflunomide combined with hydroxychloroquine (Group B,n=70),and 100 healthy volunteers were selected as controls.The lipid profile was compared between the patient groups and control group.Lipid levels,Disease Activity Score 28 (DAS28),erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured before treatment and 6 months after treatment between Group A and Group B.Results Compared with the control group,RA patients exhibited higher levels of total cholesterol (TC,P＜0.05),low-density lipoprotein cholesterol (LDL-C,P＜0.05) and triglycerides (TG,P＜0.01),and lower levels of high-density lipoprotein cholesterol (HDL-C,P＜0.05).After 6 months of treatment,the disease activity index (DAS28,P＜0.01),the duration of morning stiffness (P＜0.01),ESR,CRP,swollen joint count (SJC) and tender joint count (TJC) decreased in RA patients,compared with controls (P＜0.01 or 0.05).HDL-C levels increased and LDL-C levels decreased in Groups A and B after treatment,compared with pretreatment (P＜0.05 for all).After treatment,TC levels decreased in Group B,compared with Group A (P＜ 0.05),while TG levels had no significant difference between the two groups (P＞0.05).TC and LDL-C levels,ESR,CRP,DAS28,SJC and TJC were lower in Group B than in Group A (all P＜0.05).Conclusions Hydroxychloroquine in combination with Leflunomide therapy can not only control inflammation but also improve the lipid profile,and is more effective than single-drug therapy.The combination may reduce the risk of atherosclerosis and cardiovascular events in patients with RA.