Effect of biologic agents and inflammation on lipid levels and cardiovascular risk in rheumatoid arthritis patients
Authors' conclusion
Moderate increases in lipid levels on bDMARD treatment were not associated with an increased CVD risk by RRS regardless of the bDMARD initiated. Changes in CRP were significantly associated with changes in lipids in a mediator analysis.
Study context
- Population
- Patients with Rheumatoid Arthritis (RA) initiating a bDMARD, evaluated at baseline, 3 and 6 months1,698 bDMARD initiations analysed
- Exposure
- Individual biologic disease modifying anti-rheumatic drugs (bDMARDs) compared with each other
- Outcome
- Changes in lipid levels, Reynolds Risk Score (RRS) and Framingham risk score
- Follow-up
- 3 and 6 months
Methodological detailslongitudinal mixed effects models, structural equation models (mediation analysis)
- Longitudinal mixed effects models
- Structural equation models (mediation analysis)
Main finding
As reported in the abstract
- Significant increase in lipid levels with tocilizumab
- Reynolds Risk Score (RRS) at 3 and 6 months similar across all biologics
- Framingham risk score increased with tocilizumab
Observational data: associations, not effects.
Further findings
Mediation of lipid changes by CRP
- Mediator analyses statistically significant for the effects of CRP on lipid levels
- Association of changes from baseline CRP and LDL-C across all bDMARDs studied
LDL-C increase vs clinical response
- Increases in LDL-C from baseline independent of clinical response
Original publication
Effect of biologic agents and inflammation on lipid levels and cardiovascular risk in rheumatoid arthritis patients. Semin Arthritis Rheum. Published 29 June 2024. doi:10.
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