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Glucocorticoid use is associated with increase in HDL and no change in other lipids in rheumatoid arthritis patients

  • Original Article - Observational Research
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Abstract

The aim of this article was to examine the association of glucocorticoid use and dose and changes in the lipid profile in rheumatoid arthritis (RA) patients. RA patients between January 1, 2001, and November 30, 2011, who received oral or intravenous glucocorticoids and who had lipid levels within 1 year before and 1 year after ongoing (at least 3 months) glucocorticoids use along with RA patients who did not take glucocorticoids (controls) were included. Glucocorticoid exposure was calculated as a weighted daily dose in prednisone equivalents and analyzed using as cutoff dose prednisone equivalent of 7.5 mg/day. Outcomes were changes in high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC), triglycerides, and TC/HDL ratio and were calculated in linear regression models adjusting for relevant confounders. In total, 202 subjects on glucocorticoids and 436 controls were included. The glucocorticoid group of ≥7.5 mg/day had the greatest increase in HDL of 6.0 mg/dL (p = 0.003 compared to controls) with lower increases of 3.1 and 2.4 mg/dL in the glucocorticoid group of <7.5 mg/day and controls, respectively. There were no significant differences in other parameters of the lipid profile between the two glucocorticoid groups and controls. In this RA cohort, glucocorticoid dose equivalent of prednisone ≥7.5 mg/day was associated with increased HDL and no change in LDL or TC/HDL ratio compared to no glucocorticoid use These results suggest that this glucocorticoid dose is not associated with an atherogenic lipid profile in RA, a finding that is important in this patient population at high risk for cardiovascular disease.

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Authors and Affiliations

  1. Department of Rheumatology, Geisinger Medical Center, M.C. 21-52, 100 N. Academy Ave., Danville, PA, 17822, USA

    Lisa L. Schroeder & Androniki Bili

  2. Center for Health Research, Geisinger Health System, Danville, PA, USA

    Xiaoqin Tang & Androniki Bili

  3. Division of Rheumatology, Allegheny Health System, Pittsburgh, PA, USA

    Mary Chester M. Wasko

Authors
  1. Lisa L. Schroeder
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  2. Xiaoqin Tang
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  3. Mary Chester M. Wasko
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  4. Androniki Bili
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Corresponding author

Correspondence to Androniki Bili.

Additional information

Disclaimer: Dr. Wasko is co-investigator on two rheumatoid arthritis AstraZeneca trials and site principal investigator on two lupus UCB, Inc. trials.

Appendix

Appendix

See Tables 3 and 4.

Table 3 Stepwise regression analysis for HDL change between GC groups and controls
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Table 4 Sensitivity analysis without statins for HDL change between GC groups and controls
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Schroeder, L.L., Tang, X., Wasko, M.C.M. et al. Glucocorticoid use is associated with increase in HDL and no change in other lipids in rheumatoid arthritis patients. Rheumatol Int 35, 1059–1067 (2015). https://doi.org/10.1007/s00296-014-3194-9

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  • DOI: https://doi.org/10.1007/s00296-014-3194-9

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