Inpharma 1357 - 28 Sep 2002

Antirheumatics improve lipidprofiles in patients with RA

Effective treatment of rheumatoid arthritis (RA) isassociated with substantial improvements in adverseserum lipid profiles, report researchers from Korea andthe US.1

42 patients with newly diagnosed RA who had notpreviously received corticosteroids or disease-modifying antirheumatic drugs received standard RAtherapy for 12 months.*

After 12 months’ therapy, 27 patients (64%) wereclassified as responders, as defined by a 20%improvement from baseline in American College ofRheumatology scores. Among these patients, meanserum HDL-cholesterol levels were significantlyincreased by 21%, apolipoprotein A-I levels weresignificantly increased by 23%, and the LDL:HDL-cholesterol ratio was decreased by 13%. Analysesadjusted for baseline values revealed significantbetween-group differences for responders andnonresponders with regard to changes in HDL-cholesterol levels, apolipoprotein A-I levels, and theLDL:HDL-cholesterol ratio. There were no othersignificant between-group differences in the 12-monthchanges from baseline in lipid levels.

Moreover, among responders, the number of patientswith HDL-cholesterol levels of < 35 mg/dl wassignificantly decreased from 9 at baseline to 2 patientsafter 12 months’ therapy, whereas the number of suchpatients among nonresponders increased from 3 to 4;the between-group difference was significant.

In an accompanying editorial, Dr Bevra Hahn andcolleagues from the David Geffen School of Medicine atthe University of California Los Angeles, US, say that thedata from this study require us to ‘think twice beforeintroducing expensive preventive therapies in addition totreatment required for disease control’.2 They concludethat ‘it may be advisable to wait a few months and toreassess lipid levels before committing patients to long-term treatment with lipid-lowering agents’.* Standard RA therapy comprised methotrexate, other disease-modifying antirheumatic drugs, and prednisolone.

1. Park Y-B, et al. Effects of antirheumatic therapy on serum lipid levels inpatients with rheumatoid arthritis: a prospective study. American Journal ofMedicine 113: 188-193, 15 Aug 2002.

2. Hahn BH, et al. Improving joint disease in patients with rheumatoid arthritis: isthis enough to treat the accompanying dyslipidemias? American Journal ofMedicine 113: 247-248, 15 Aug 2002.

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Inpharma 28 Sep 2002 No. 13571173-8324/10/1357-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved