RESEARCH = Sustained changes in lipid profile and MIF levels after anti-TNF therapy in RA

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Ann Rheum Dis. 2008 Aug 22.

Sustained changes in lipid profile and macrophage migration inhibitory

factor (MIF) levels after anti-TNF therapy in rheumatoid arthritis.

Wijbrandts CA, van Leuven SI, Boom HD, Gerlag DM, Stroes ES, Kastelein

JJ, Tak PP.

Academic Medical Center/University of Amsterdam, Netherlands.

BACKGROUND: Macrophage migration inhibitory factor (MIF) has recently

emerged as an important cytokine possibly linking rheumatoid arthritis

(RA) and atherogenesis. Because atherogenesis is accelerated in RA we

investigated whether anti-TNF therapy could lead to sustained

downregulation of systemic MIF levels and improvement of lipid

profiles. METHODS: Fifty RA patients with active disease (disease

activity score 28 (DAS28 " d 3.2)), who started adalimumab therapy 40

mg every other week, were included. At baseline, week 16 and 52 serum

levels of MIF and lipids were assessed. In addition, the DAS28 and

serum C-reactive protein (CRP) levels and erythrocyte sedimentation

rate (ESR) were determined. RESULTS: After 16 weeks of adalimumab

therapy, both DAS28 and MIF levels were significantly decreased (P <

0.001 and P = 0.020, respectively). This was sustained up to week 52

(P < 0.001 and P = 0.012, respectively). CRP levels and ESR were

significantly reduced after 16 and 52 weeks of adalimumab therapy (P <

0.001). HDL cholesterol levels increased at week 16 (P < 0.001), but

returned to baseline at week 52. Apo A-I levels increased at week 16

(P <0.001) and remained stable (P = 0.005). This resulted in an

improved apo B/ A-I ratio.

CONCLUSIONS: Our results underline sustained downregulation of MIF as

a potential new mechanism by which anti-TNF therapy might reduce

vascular inflammation, and as such perhaps cardiovascular morbidity in

RA patients. This hypothesis is supported by an improved apo B/ A-I

ratio as well as reduced CRP levels in our patients.

PMID: 18723565

http://www.ncbi.nlm.nih.gov/pubmed/18723565

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