Biologics: Targets & Therapy (Oct 2022)
TNF Inhibitors Exert a “Hidden” Beneficial Effect in the Cardiovascular Lipoprotein Profile of RA Patients
Abstract
Jaime Calvo Alén,1 Bernardo Alio Lavin-Gomez,2 Elena Aurrecoechea,3 Armando Raul Guerra Ruiz,2 Víctor Martínez Taboada,4 Juan Gómez Gerique2, † 1Rheumatology Department, Hospital Universitario Araba, Universidad del País Vasco, and Instituto de Investigación Biomédica BIOARABA, Vitoria, Spain; 2Clinical Biochemistry Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain; 3Rheumatology Division, Hospital Universitario Sierrallana, Torrelavega, Spain; 4Rheumatology Department, Hospital Universitario Marqués de Valdecilla Universidad de Cantabria, Santander, Spain†Juan Gómez Gerique passed away on 30 December 2015Correspondence: Jaime Calvo Alén, Rheumatology Department, Hospital Universitario Araba, Universidad del País Vasco, C/ Francisco Leandro de Viana s/n, Vitoria, Alava, 01009, Spain, Tel +34 945007576, Email [email protected]: A high cardiovascular risk has been described in patients with rheumatoid arthritis (RA); the effects of different biological agents have also been described in these patients. The aim of the present study is to examine the effects of tumor necrosis factor inhibitors (TNFi) in the lipoprotein profile of RA patients using a broad laboratory assessment including a large number of non-routine tests.Patients and Methods: RA patients treated with and without TNFi (70 patients in each group) were cross-sectionally compared regarding a broad spectrum of lipoprotein parameters including serum levels of total and HDL, LDL and VLDL cholesterol triglycerides, lipoprotein A (LpA), apolipoprotein A1 (Apo A), B100 (Apo B) and paroxonase. For each lipoprotein subfraction (HDL, LDL and VLDL), we assess specific concentrations of cholesterol, triglycerides, phospholipids and proteins and total mass of each one. Additionally, HDL Apo A, LDL and VLDL Apo B concentrations and number of particles of LDL and VLDL were also determined. Exploratory univariate and multivariate analyses of the different variables were performed.Results: Seventy patients in each subset were enrolled. Patients on treatment with TNFi showed a trend to be younger and to have a longer disease duration. Regarding the lipoprotein analyses, borderline significant higher levels of serum Apo A were detected and an independent association with lower HDL mass, LDL triglyceride, VLDL cholesterol, VLDL Apo B, VLDL mass, number of VLDL cholesterol molecules and number of particles of VLDL was clearly observed.Conclusion: TNFi treatment was associated with beneficial atherogenic effects at the lipoprotein level especially centered in the VLDL-related parameters consistent with a reduction of the atherogenic risk.Keywords: rheumatoid arthritis, lipoproteins, tumor necrosis factor inhibitors
