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Decreased disease activity in patients with RA may improve cholesterol profile
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A decrease in disease activity with either methotrexate plus etanercept or triple therapy with methotrexate, sulfasalazine and hydroxychloroquine concomitantly was associated with an increase in HDL levels, lower LDL levels and a lower total cholesterol-to-HDL levels, according to recently published research. The same effects were not observed with methotrexate monotherapy.
Researchers studied data from the Treatment of Early Aggressive Rheumatoid Arthritis (TEAR) trial of 755 patients with early rheumatoid arthritis (RA) to prior disease-modifying antirheumatic drugs who were randomly assigned to either methotrexate monotherapy, methotrexate plus etanercept or triple therapy with methotrexate, sulfasalazine and hydroxychloroquine. Patients who received methotrexate monotherapy but did not achieve low disease activity were switched to the addition of etanercept or triple therapy. Each treatment study arm was matched with a placebo arm. Patients who received methotrexate monotherapy trended toward a younger age compared to the other groups, but no other differences in demographics were apparent between groups. Triglycerides, HDL and LDL cholesterol levels were measured from serum obtained from 416 patients at 24 weeks, 48 weeks and 102 weeks of the study.
At 24 weeks, total cholesterol levels on average were elevated compared to baseline and later decreased significantly. At week 102, LDL and HDL cholesterol and total cholesterol were decreased compared to week 24 in all treatment groups, except in patients who received methotrexate monotherapy. Decreases in cholesterol levels correlated with reductions in markers of inflammation, including C-reactive protein and erythrocyte sedimentation rate between 6 months and 2 years of study. – by Shirley Pulawski
Disclosures: The researchers report the study was supported by grant R21-AR-057913-01A1 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH and by a grant from the Arthritis Foundation. Please see the full study for a list of all other authors’ relevant financial disclosures.
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