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Semin Arthritis Rheum. 2016 Aug;46(1):71-80. doi: 10.1016/j.semarthrit.2016.03.004. Epub 2016 Mar 9.

Effects of tofacitinib and other DMARDs on lipid profiles in rheumatoid arthritis: implications for the rheumatologist.

Author information

1
University of California, Los Angeles, CA. Electronic address: CCharles@mednet.ucla.edu.
2
Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain.
3
Pfizer Inc., Groton, CT.
4
Pfizer Inc., New York, NY.
5
Pfizer Inc., Shanghai, China.

Abstract

Cardiovascular (CV) morbidity and mortality are increased in patients with active, untreated rheumatoid arthritis (RA), despite lower levels of total and low-density lipoprotein cholesterol reported in individuals with active RA compared with those without RA. Alterations in non-traditional lipid assessments, such as high-density lipoprotein (HDL) function and HDL-associated proteins, have been described in patients with active RA, including elevated HDL-associated serum amyloid A and decreased paraoxonase-1 activity. We review changes in both traditional lipoprotein concentrations and non-traditional lipoprotein assessments in multiple studies of treatment with disease-modifying antirheumatic drugs (DMARDs), including non-biologic and biologic DMARDs and tofacitinib. In addition, data from a recently published clinical trial with tofacitinib that describe a potential mechanism for suppression of cholesterol levels in active RA patients are reviewed. Finally, CV event data from various studies of DMARDs are presented, and the current management of RA patients with regard to the CV risk is reviewed.

KEYWORDS:

Disease-modifying antirheumatic drugs; Janus kinase; Rheumatoid arthritis; TNF inhibitors; Tofacitinib

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