Sue Plaster - Arava & cholesterol - more

[Guest guest]

Sue,

Here's the study abstract from the ACR meeting that the previous

article referenced. If you can get HTML in your private box, I've

included the graph. If not, you can go to the abstracts and get it

yourself at:

http://www.rheumatology.org/abstracts/entry.htm

(just use some of the information from below like the authors'

names or " lipid " and " leflunomide " )

I'd give you the URLs, but they're very ugly.

Maybe your rheumatologist should be reading the abstracts,

LOL!!!?????

Leflunomide Induces Progressive Increase in Rheumatoid Arthritis

Lipid Profile

Category: 17 RA-treatment

Aleksander S. Prokopowitsch, HM Diógenes,Cláudia T.Borges,

Dawton Torigoe, Jussara Kochen,, Ieda M M Laurindo

Division of Rheumatology, University of São o, São o,

Brazil

Presentation Number: 352

Poster Board Number: 352

Keywords: Leflunomide, Cholesterol, LDL

Cardiovascular disease is the main cause of premature death

in RA patients. Recent studies have suggested a role for RA as an

independent risk factor for atherosclerosis and cardiovascular disease.

Some DMARDs are known to interfere with serum lipids. Leflunomide (LEF)

is a new therapeutic option for RA, and its effect on lipid levels has

yet not been evaluated. Therefore, the aim of this study was to assess

LEF activity on RA lipid profile. Methods - 17 RA patients (ACR

criteria), mean age of 43 years (range 32-61), mean disease duration of

12 years (5-27years), 16 with positive RF, received LEF 20mg/day after a

loading dose of 100mg/3days during 18 months. No patient had familiar

dyslipoproteinemia, obesity, diabetes, renal disease or thyroid

dysfunction. During follow-up the patients were on stable doses of

NSAIDs and corticosteroids. None were taking hormone replacement or

diuretic therapy. Plasma lipids were determined after 12h over-night

fast. Lipids pre-treatment levels were compared with values after 6, 12

and 18 months of LEF administration. Clinical parameters of disease

activity were recorded and DAS 28 calculated. Total cholesterol (TC) and

(LDL) levels were significantly enhanced in each time point (6, 12 and

18 months) when compared with pre-treatment levels (paired T, p<0.01) as

shown:

Increased levels of cholesterol and LDL were consistently

observed in 88% of the patients with a mean final increase of 17% and

27% respectively. Triglycerides levels were increased only after 18

months of LEF use (89±10 vs. 125±13.3mg/dl, p=0.04). In contrast, no

change in high density lipoprotein (HDL) and very low density

lipoprotein (VLDL) serum levels was observed. A significant increase in

LDL/HDL ratio was detected (from 2.1±0.2 to 2.9±0.4, p<0.02). No

correlation with disease activity was verified.

Conclusion: this study provides compelling evidence of a

progressive deleterious effect of Leflunomide on RA lipid profile. A

close monitoring of these abnormalities is therefore essential in order

to institute preventive measures.

[ ] Cholesterol & Arava - or a

> or a,

>

> I had an appointment with my rheumy yesterday. When I told him that

Arava

> had raised my cholesterol from 199 to 232, he said, " Arava doesn't

raise

> cholesterol. Where did you read that? "

>

> I'd like to send him the article that one of you sent about Arava

raising

> cholesterol, but I've deleted that email. I've not had any luck

finding it

> by doing a search, either. So if one of you still has it, I'd be most

> grateful if you could post it again.

>

> I did find in the Prescribing Information on the Arava website, way at

the

> bottom in fine print, this statement:

>

> " In addition, the following adverse events have been reported in 1% to

<3%

> of the RA patients in the leflunomide treatment group in controlled

clinical

> trials.

>

>

> " Metabolic and Nutritional: creatine phosphokinase increased,

hyperglycemia,

> hyperlipidemia, peripheral edema; "

>

> Thanks so much, Sue in NC