Anti-TNF alpha therapy transiently improves high density lipoprotein cholesterol levels and microvascular endothelial function in patients with rheumatoid arthritis: a Pilot Study

作者：Sandoo Aamer^*; van Zanten Jet J C S Veldhuijzen; Toms Tracey E; Carroll Douglas; Kitas George D

来源：BMC Musculoskeletal Disorders, 2012, 13: 127.

DOI：10.1186/1471-2474-13-127

• Dyslipidaemia
• Anti-TNF alpha
• Endothelial function
• Rheumatoid arthritis
• Cardiovascular disease

Background: Rheumatoid arthritis (RA) is associated with increased morbidity and mortality from cardiovascular disease (CVD). This can be only partially attributed to traditional CVD risk factors such as dyslipidaemia and their downstream effects on endothelial function. The most common lipid abnormality in RA is reduced levels of high-density lipoprotein (HDL) cholesterol, probably due to active inflammation. In this longitudinal study we hypothesised that anti-tumor necrosis factor-alpha (anti-TNF alpha) therapy in patients with active RA improves HDL cholesterol, microvascular and macrovascular endothelial function. %26lt;br%26gt;Methods: Twenty-three RA patients starting on anti-TNF alpha treatment were assessed for HDL cholesterol level, and endothelial-dependent and -independent function of microvessels and macrovessels at baseline, 2-weeks and 3 months of treatment. %26lt;br%26gt;Results: Disease activity (CRP, fibrinogen, DAS28) significantly decreased during the follow-up period. There was an increase in HDL cholesterol levels at 2 weeks (p%26lt;0.05) which was paralleled by a significant increase in microvascular endothelial-dependent p%26lt;0.05). However, both parameters returned towards baseline at 12 weeks. %26lt;br%26gt;Conclusion: Anti-TNF alpha therapy in RA patients appears to be accompanied by transient but significant improvements in HDL cholesterol levels, which coexists with an improvement in microvascular endothelial-dependent function.

• 出版日期2012-7-23