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Research ArticleArticle

High-density Lipoprotein Profiling Changes in Patients with Rheumatoid Arthritis Treated with Tumor Necrosis Factor Inhibitors: A Cohort Study

Anna Jamnitski, Johannes H. Levels, Inge A. van den Oever and Michael T. Nurmohamed
The Journal of Rheumatology June 2013, 40 (6) 825-830; DOI: https://doi.org/10.3899/jrheum.121358
Anna Jamnitski
From the Jan van Breemen Research Institute; Academic Medical Centre Amsterdam; and VU University Medical Centre, Amsterdam, The Netherlands.
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Johannes H. Levels
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Inge A. van den Oever
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Michael T. Nurmohamed
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  • For correspondence: m.nurmohamed@reade.nl
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    Figure 1.

    Dynamics of the serum amyloid A (SAA)-1 and -2 markers stratified for EULAR response. The mean values (± 1 SD) of the 4 markers correspond with the SAA isoforms as present in the nonresponders and responders. The corresponding timepoints are baseline (T0), 1 month (T1), and after 4 months after the start of therapy (T4). §p < 0.05, *p < 0.001 using 1-way ANOVA with Bonferroni multiple comparison. AU: arbitrary unit.

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    Table 1.

    Demographic and clinical characteristics at baseline. Mean values (SD), or mean ± SD, or count (percentage) are shown unless indicated.

    CharacteristicAll Patients, n = 100EULAR Responders, n = 50EULAR Nonresponders, n = 50
    Age, yrs52 ± 1049 ± 11*56 ± 8*
    Female, %878886
    Disease duration, yrs5 (2–13)5 (2–10)7 (3–15)
    RF-positive, %677262
    Erosive disease, %666666
    DAS284.7 ± 1.04.9 ± 0.84.6 ± 1.2
    ESR, mm/h16 (8–33)15 (8–24)18 (8–39)
    CRP, mg/l6 (3–19)6 (3–21)6 (3–17)
    HAQ1.1 ± 0.61.1 ± 0.61.1 ± 0.7
    Prior DMARD2.9 ± 1.12.8 ± 1.12.9 ± 1.2
    MTX use, %798672
    MTX dose, mg/wk21.5 ± 6.321.4 ± 5.921.5 ± 6.9
    Prednisolone use, %262626
    Prednisolone dose, mg/day6.7 ± 4.25.2 ± 3.08.2 ± 4.7
    Other DMARD than MTX, %293622
    Cardiovascular risk factors
      Body mass index25.5 ± 4.724.9 ± 4.026.1 ± 5.2
      Hypertension, %231422
      Diabetes mellitus, %422
      Current smoking, %262626
      Statin use, %12816
    Lipid profile
      Total cholesterol, mmol/l5.0 ± 1.04.9 ± 1.05.0 ± 1.0
      Triglycerides, mmol/l1.3 ± 0.51.2 ± 0.51.3 ± 0.5
      HDL cholesterol, mmol/l1.3 ± 0.51.2 ± 0.41.3 ± 0.5
      LDL cholesterol, mmol/l3.3 ± 0.83.3 ± 0.83.4 ± 0.8
      Total cholesterol/HDL ratio4.4 ± 1.94.4 ± 2.04.4 ± 1.8
      ApoA-I, mg/dl178 ± 36178 ± 33179 ± 39
      ApoA-II, mg/dl30 ± 729 ± 631 ± 8
      ApoB, mg/dl122 ± 31120 ± 33125 ± 29
      ApoE, mg/dl4.4 ± 2.14.7 ± 2.54.1 ± 1.6
      ApoC-III, mg/dl9.9 ± 3.39.3 ± 2.910.6 ± 3.6
      ApoB/ApoA-I ratio0.7 ± 0.30.7 ± 0.30.7 ± 0.3
    • ↵* Patients with European League Against Rheumatism (EULAR) good response were significantly younger than EULAR nonresponders (p < 0.001). IQR: interquartile range; RF: rheumatoid factor; DAS28: Disease Activity Score of 28 joints; ESR: erythrocyte sedimentation rate; CRP: C-reactive protein; DMARD: disease-modifying antirheumatic drugs; MTX: methotrexate; HAQ: Health Assessment Questionnaire; HDL: high-density lipoprotein; LDL: low-density lipoprotein; apo: apolipoproteins.

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    Table 2.

    Changes in lipid levels according to EULAR response at 1 and 4 months of therapy.

    Baseline1 Month4 Months
    EULAR nonresponders
      Total cholesterol, mmol/l5.03 ± 0.965.09 ± 1.104.98 ± 1.03
      Triglycerides, mmol/l1.32 ± 0.541.29 ± 0.531.23 ± 0.49
      HDL cholesterol, mmol/l1.29 ± 0.501.30 ± 0.511.30 ± 0.46
      LDL cholesterol, mmol/l3.40 ± 0.763.42 ± 0.823.34 ± 0.78
      Total cholesterol/HDL ratio4.39 ± 1.764.41 ± 1.694.23 ± 1.65
      ApoA-I, mg/dl1.79 ± 0.391.78 ± 0.321.79 ± 0.31
      ApoA-II, mg/dl0.31 ± 0.080.32 ± 0.090.31 ± 0.08
      ApoB, mg/dl1.25 ± 0.291.26 ± 0.331.21 ± 0.28
      ApoE, mg/dl0.04 ± 0.020.04 ± 0.020.04 ± 0.01
      ApoC-III, mg/dl0.11 + 0.040.11 ± 0.040.10 ± 0.03
      ApoB/ApoA-I ratio0.75 ± 0.340.73 ± 0.210.74 ± 0.31
    EULAR good responders
      Total cholesterol, mmol/l4.88 ± 0.964.78 ± 0.884.95 ± 1.02
      Triglycerides, mmol/l1.19 ± 0.531.18 ± 0.601.26 ± 0.60
      HDL cholesterol, mmol/l1.24 ± 0.401.27 ± 0.44*1.30 ± 0.39*
      LDL cholesterol, mmol/l3.30 ± 0.833.16 ± 0.753.26 ± 0.85
      Total cholesterol/HDL ratio4.38 ± 1.984.16 ± 1.53*4.16 ± 1.66*
      ApoA-I, g/l1.78 ± 0.331.75 ± 0.251.78 ± 0.33
      ApoA-II, g/l0.29 ± 0.060.31 ± 0.06*0.31 ± 0.06*
      ApoB, g/l1.20 ± 0.331.14 ± 0.30*1.18 ± 0.31*
      ApoE, g/l0.05 ± 0.030.04 ± 0.030.05 ± 0.02
      ApoC-III, g/l0.09 ± 0.030.09 ± 0.030.10 ± 0.03
      ApoB/ApoA-I ratio0.70 ± 0.260.67 ± 0.21*0.67 ± 0.23*
    • ↵* Generalized estimating equation analyses were used to test for longitudinal changes in lipids. There were significant differences at 1 and 4 months of therapy compared to baseline for HDL (p = 0.006), TC/HDL ratio (p = 0.014), ApoA-II (p = 0.004), ApoB (p = 0.013), and ApoB/ApoA-I ratio (p = 0.001). EULAR: European League Against Rheumatism; HDL: high-density lipoprotein; LDL: low-density lipoprotein; apo: apolipoproteins.

  • Details of mass charge markers in nonresponders (signal in relative units).

    Table1
  • Details of mass charge markers in responders (signal in relative units).

    Table2
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The Journal of Rheumatology
Vol. 40, Issue 6
1 Jun 2013
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High-density Lipoprotein Profiling Changes in Patients with Rheumatoid Arthritis Treated with Tumor Necrosis Factor Inhibitors: A Cohort Study
Anna Jamnitski, Johannes H. Levels, Inge A. van den Oever, Michael T. Nurmohamed
The Journal of Rheumatology Jun 2013, 40 (6) 825-830; DOI: 10.3899/jrheum.121358

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High-density Lipoprotein Profiling Changes in Patients with Rheumatoid Arthritis Treated with Tumor Necrosis Factor Inhibitors: A Cohort Study
Anna Jamnitski, Johannes H. Levels, Inge A. van den Oever, Michael T. Nurmohamed
The Journal of Rheumatology Jun 2013, 40 (6) 825-830; DOI: 10.3899/jrheum.121358
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Keywords

RHEUMATOID ARTHRITIS
HIGH-DENSITY LIPOPROTEINS
LIPID PROFILE
TUMOR NECROSIS FACTOR INHIBITORS
CARDIOVASCULAR RISK

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Keywords

  • rheumatoid arthritis
  • HIGH-DENSITY LIPOPROTEINS
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  • TUMOR NECROSIS FACTOR INHIBITORS
  • CARDIOVASCULAR RISK

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