Changes in lipid profile during infliximab treatment for rheumatoid arthritis

ABSTRACT

To evaluate the changes in lipid profile in early diagnosed active Rheumatoid Arthritis [RA] patients as well as the effect of immuno-intervention with the anti tumor necrosis factor alpha [anti-TNF-alpha] infliximab on the atherogenic index. Eighteen patients with early RA [disease durations of less than one year] were included. Infusions with infliximab were given at weeks 0, 2, 6, then 8 weeks. Infliximab was administered intravenously at a starting dose of 3 mg/Kg. Blood samples [fasting] were collected at 0 then at 8 weeks. Total serum cholesterol and triglycerides were measured using Roche clinical chemistry analysis. HDL-cholesterol was determined with polyethylene glycol-modified enzymes. The atherogenic index was calculated using the following formula atherogenic index= total / HDL-cholesterol. Treatment with infliximab leads to a significantly better DAS 28 score at 8 weeks as compared with base line 5.4 versus 4.45. Following 8 weeks of treatment, mean total cholesterol [TC] levels increased from 4.55 to 4.86 nmol/L that were statistically significant. However, high density lipoprotein cholesterol [HDL-cholesterol] levels were more or less steady, resulting in slight decrease in the atherogenic index that was statistically not significant when compared with base line. Triglycerides [TG] and low density lipoprotein [LDL-cholesterol] mean levels were significantly decreased. Anti-TNF treatment might affect lipid profile in RA patients. In view of the clear relationship between disease activity and cardiovascular disease in RA a tight disease control is mandatory. This might have favorable effects on the lipid profile and hence it might also decrease CVD risk