Influence of anti-TNF treatment on the cardiovascular risk factors in patients with active RA

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Ann Rheum Dis. 2004 Jul 1 [Epub ahead of print]

Influence of anti-TNF treatment on the cardiovascular risk factors in

patients with active rheumatoid arthritis.

Popa C, Netea MG, Radstake T, Van Der Meer JW, Stalenhoef AF, Van Riel

PL, Barrera P.

UMC St.Radboud Nijmegen, The Netherlands.

OBJECTIVES: Tumor necrosis factor (TNF) is known to increase the

concentrations of IL-6 and CRP and to induce pro-atherogenic changes in

the lipid profile and could increase the cardiovascular risk of patients

with rheumatoid arthritis (RA) and other inflammatory disorders. The aim

of this study is to assess whether anti-TNF therapy modifies the

cardiovascular risk profile in patients with RA. METHODS: We

investigated the lipoprotein spectrum and the inflammation markers CRP

and IL-6 in 33 RA patients treated with human anti-TNF monoclonal

antibodies (D2 E7, adalimumab, Humira ®) and 13 RA patients given

placebo, before and after two weeks therapy. RESULTS: In the anti-TNF

treated group, the concentrations of HDL-cholesterol were significantly

higher after 2 weeks therapy (0.86 + 0.30 mmol/L vs 0.98 + 0.33 mmol/L,

p<0.01), whereas LDL and triglyceride levels were not significantly

changed. In addition, a significant decrease in CRP (86.1 + 54.4 mg/L vs

35.4 + 35.0 mg/L p < 0.01), and IL-6 (88.3 + 60.5 pg/mL vs 42.3 + 40.7

pg/mL p < 0.01) concentrations was observed in this group. No changes in

lipid profile, IL-6 or CRP levels were seen in the placebo group.

CONCLUSIONS: TNF neutralization with monoclonal anti-TNF antibodies

results in increased HDL-cholesterol levels and decreased CRP and IL-6

levels already after 2 weeks. Therefore this therapy may improve the

cardiovascular risk profile of patients with RA.

PMID: 15231512

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