Changes in serum lipids in patients with rheumatoid arthritis treated with a combination of tocilizumab and methotrexate compared with methotrexate alone for 24 weeks of observation

Background. According to the some studies tocilizumab therapy (TCZ) in patients with rheumatoid arthritis (RA) is accompanied by deterioration of blood lipid profile. Aim. To study changes in serum lipid parameters in patients with RA treated with a combination of tocilizumab and methotrexate compar...

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Main Authors: E. V. Udachkina, D. S. Novikova, T. V. Popkova, E. Yu. Panasyuk, A. S. Avdeeva, A. V. Volkov, I. G. Kirillova, E. I. Markelova, E. N. Aleksandrova, A. A. Novikov, E. L. Nasonov
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Language:English
Published: Столичная издательская компания 2015-11-01
Series:Рациональная фармакотерапия в кардиологии
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Online Access:https://www.rpcardio.online/jour/article/view/325
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author E. V. Udachkina
D. S. Novikova
T. V. Popkova
E. Yu. Panasyuk
A. S. Avdeeva
A. V. Volkov
I. G. Kirillova
E. I. Markelova
E. N. Aleksandrova
A. A. Novikov
E. L. Nasonov
author_facet E. V. Udachkina
D. S. Novikova
T. V. Popkova
E. Yu. Panasyuk
A. S. Avdeeva
A. V. Volkov
I. G. Kirillova
E. I. Markelova
E. N. Aleksandrova
A. A. Novikov
E. L. Nasonov
author_sort E. V. Udachkina
collection DOAJ
description Background. According to the some studies tocilizumab therapy (TCZ) in patients with rheumatoid arthritis (RA) is accompanied by deterioration of blood lipid profile. Aim. To study changes in serum lipid parameters in patients with RA treated with a combination of tocilizumab and methotrexate compared with methotrexate alone for 24 weeks of observation. Material and methods. Patients (n=72) with RA were included into the pilot non-randomized 24-week study and divided in two groups: 1) TCZ+MTX group (n=39; women 30; median age 51 [43-55] years; 6 i.v. infusions of TCZ 8 mg/kg + МТX 10-20 mg/week); 2) MTX group (n=33; women 23; mеdian age 56 [48-63] years; MTX 7.5-20 mg/week). Results. At the baseline, similar proatherogenic blood profile was observed in both groups. The patients of MTX group more frequently took statins (n=19; 57.6%) compared with the group TCZ+MTX (n=7; 18%), (p<0.05). The lipid levels correlated positively with traditional risk factors (p<0.05). RA activity and duration correlated negatively with high density lipoprotein cholesterol (HDL-C), (p<0.05). Good/satisfactory anti-inflammatory effect was achieved in both groups after 24 weeks of treatment. Patients of TCZ+MTX group showed an increase in total cholesterol and HDL-C levels by 11% and 110%, respectively and decrease in plasma atherogenic index (PAI) by 47%, (p<0.05). HDL-C level increased by 22% and PAI decreased by 16% in patients of MTX group (p<0.05). Among patients of MTX group without statin therapy HDL-C as well as non-HDL-C levels were increased by 24% and 27%, respectively (p<0.05); PAI did not change significantly in this subgroup. Among patients of MTX group treated with statins isolated increase in HDL-C level by 22% and decrease in PAI by 37.3% (p<0.05) were observed. A number of patients with achieved target levels of all studied lipid parameters did not change significantly in both groups. Conclusions. TCZ+MTX combined therapy as well as MTX monotherapy are associated with similar improvement in lipid parameters. Adjusted statin doses may be needed to achieve target serum lipid profile in RA patients.
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spelling doaj-art-d5bbb68750944b14bc6e2c989452f9922025-08-23T10:00:18ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532015-11-0111551051610.20996/1819-6446-2015-11-5-510-516325Changes in serum lipids in patients with rheumatoid arthritis treated with a combination of tocilizumab and methotrexate compared with methotrexate alone for 24 weeks of observationE. V. Udachkina0D. S. Novikova1T. V. Popkova2E. Yu. Panasyuk3A. S. Avdeeva4A. V. Volkov5I. G. Kirillova6E. I. Markelova7E. N. Aleksandrova8A. A. Novikov9E. L. Nasonov10V.A. Nasonova Research Institute of Rheumatology, Kashirskoe shosse 34A, Moscow, 155522 RussiaV.A. Nasonova Research Institute of Rheumatology, Kashirskoe shosse 34A, Moscow, 155522 RussiaV.A. Nasonova Research Institute of Rheumatology, Kashirskoe shosse 34A, Moscow, 155522 RussiaV.A. Nasonova Research Institute of Rheumatology, Kashirskoe shosse 34A, Moscow, 155522 RussiaV.A. Nasonova Research Institute of Rheumatology, Kashirskoe shosse 34A, Moscow, 155522 RussiaV.A. Nasonova Research Institute of Rheumatology, Kashirskoe shosse 34A, Moscow, 155522 RussiaV.A. Nasonova Research Institute of Rheumatology, Kashirskoe shosse 34A, Moscow, 155522 RussiaV.A. Nasonova Research Institute of Rheumatology, Kashirskoe shosse 34A, Moscow, 155522 RussiaV.A. Nasonova Research Institute of Rheumatology, Kashirskoe shosse 34A, Moscow, 155522 RussiaV.A. Nasonova Research Institute of Rheumatology, Kashirskoe shosse 34A, Moscow, 155522 RussiaV.A. Nasonova Research Institute of Rheumatology, Kashirskoe shosse 34A, Moscow, 155522 RussiaBackground. According to the some studies tocilizumab therapy (TCZ) in patients with rheumatoid arthritis (RA) is accompanied by deterioration of blood lipid profile. Aim. To study changes in serum lipid parameters in patients with RA treated with a combination of tocilizumab and methotrexate compared with methotrexate alone for 24 weeks of observation. Material and methods. Patients (n=72) with RA were included into the pilot non-randomized 24-week study and divided in two groups: 1) TCZ+MTX group (n=39; women 30; median age 51 [43-55] years; 6 i.v. infusions of TCZ 8 mg/kg + МТX 10-20 mg/week); 2) MTX group (n=33; women 23; mеdian age 56 [48-63] years; MTX 7.5-20 mg/week). Results. At the baseline, similar proatherogenic blood profile was observed in both groups. The patients of MTX group more frequently took statins (n=19; 57.6%) compared with the group TCZ+MTX (n=7; 18%), (p<0.05). The lipid levels correlated positively with traditional risk factors (p<0.05). RA activity and duration correlated negatively with high density lipoprotein cholesterol (HDL-C), (p<0.05). Good/satisfactory anti-inflammatory effect was achieved in both groups after 24 weeks of treatment. Patients of TCZ+MTX group showed an increase in total cholesterol and HDL-C levels by 11% and 110%, respectively and decrease in plasma atherogenic index (PAI) by 47%, (p<0.05). HDL-C level increased by 22% and PAI decreased by 16% in patients of MTX group (p<0.05). Among patients of MTX group without statin therapy HDL-C as well as non-HDL-C levels were increased by 24% and 27%, respectively (p<0.05); PAI did not change significantly in this subgroup. Among patients of MTX group treated with statins isolated increase in HDL-C level by 22% and decrease in PAI by 37.3% (p<0.05) were observed. A number of patients with achieved target levels of all studied lipid parameters did not change significantly in both groups. Conclusions. TCZ+MTX combined therapy as well as MTX monotherapy are associated with similar improvement in lipid parameters. Adjusted statin doses may be needed to achieve target serum lipid profile in RA patients.https://www.rpcardio.online/jour/article/view/325rheumatoid arthritistocilizumabmethotrexatlipidsstatins
spellingShingle E. V. Udachkina
D. S. Novikova
T. V. Popkova
E. Yu. Panasyuk
A. S. Avdeeva
A. V. Volkov
I. G. Kirillova
E. I. Markelova
E. N. Aleksandrova
A. A. Novikov
E. L. Nasonov
Changes in serum lipids in patients with rheumatoid arthritis treated with a combination of tocilizumab and methotrexate compared with methotrexate alone for 24 weeks of observation
Рациональная фармакотерапия в кардиологии
rheumatoid arthritis
tocilizumab
methotrexat
lipids
statins
title Changes in serum lipids in patients with rheumatoid arthritis treated with a combination of tocilizumab and methotrexate compared with methotrexate alone for 24 weeks of observation
title_full Changes in serum lipids in patients with rheumatoid arthritis treated with a combination of tocilizumab and methotrexate compared with methotrexate alone for 24 weeks of observation
title_fullStr Changes in serum lipids in patients with rheumatoid arthritis treated with a combination of tocilizumab and methotrexate compared with methotrexate alone for 24 weeks of observation
title_full_unstemmed Changes in serum lipids in patients with rheumatoid arthritis treated with a combination of tocilizumab and methotrexate compared with methotrexate alone for 24 weeks of observation
title_short Changes in serum lipids in patients with rheumatoid arthritis treated with a combination of tocilizumab and methotrexate compared with methotrexate alone for 24 weeks of observation
title_sort changes in serum lipids in patients with rheumatoid arthritis treated with a combination of tocilizumab and methotrexate compared with methotrexate alone for 24 weeks of observation
topic rheumatoid arthritis
tocilizumab
methotrexat
lipids
statins
url https://www.rpcardio.online/jour/article/view/325
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