Improvements in RA disease activity may improve HDL function

Early reduction of disease activity in patients with rheumatoid arthritis may help improve high density lipoprotein levels, according to recently published research.

Researchers studied data from 550 patients enrolled in the Treatment of Early Rheumatoid Arthritis (TEAR) 2-year trial. Patients had minimal prior use of disease-modifying anti-rheumatic drugs (DMARDs) and were randomly assigned to receive methotrexate monotherapy, methotrexate combined with etanercept (Enbrel, Amgen) or triple therapy. Patients who did not achieve low disease activity with methotrexate monotherapy after 6 months were randomly assigned to methotrexate in combination with etanercept or to triple therapy. Patients in all groups had a mean disease duration of less than 4.3 months and more than 84% were positive for rheumatoid factor. The groups had similar demographics, including smoking status, sex, race and BMI.

Investigators found high density lipoprotein (HDL)-associated haptoglobin was lowest in the triple therapy and stepped-up triple therapy groups at 102 weeks. Reductions in C-reactive protein (CRP) levels were associated with decreases in the HDL inflammatory index and HDL-associated haptoglobin. Reduced inflammation was also modestly associated with increases in paraoxonase 1 and HDL-associated apolipoprotein AI. The correlations remained after multivariate analysis.

A 10-unit decrease in CRP was linked with a 2.34% decrease in the HDL inflammatory index, a 3.53% decrease in HDL-associated haptoglobin, a 3.42% increase in paraoxonase activity and an 8.74% increase in HDL-associated apolipoprotein AI.

Women had lower myeloperoxidase levels by up to 16% compared to men, and higher BMI was associated with a higher HDL inflammatory index. A modest association was observed with baseline use of statins and a lower HDL inflammation index and better HDL antioxidant function. - by Shirley Pulawski

Disclosures: Amgen provided funding for the trial. Please see the full study for a list of all other authors’ relevant financial disclosures.

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Source:

Charles-Shoeman C. Arth & Rheumatol. 2016;doi:10.1002/art.39833.