Reduction of Inflammation Drives Lipid Changes in Ankylosing Spondylitis

Sjoerd C Heslinga; Mike J Peters; Marieke M Ter Wee; Irene E van der Horst-Bruinsma; Alper M van Sijl; Yvo M Smulders; Michael T Nurmohamed

doi:10.3899/jrheum.150193

Reduction of Inflammation Drives Lipid Changes in Ankylosing Spondylitis

J Rheumatol. 2015 Oct;42(10):1842-5. doi: 10.3899/jrheum.150193. Epub 2015 Sep 1.

Authors

Sjoerd C Heslinga¹, Mike J Peters², Marieke M Ter Wee², Irene E van der Horst-Bruinsma², Alper M van Sijl², Yvo M Smulders², Michael T Nurmohamed²

Affiliations

¹ From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade and VU University Medical Center; and Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands.S.C. Heslinga, MD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; M.J. Peters, MD, PhD, Department of Internal Medicine, VU University Medical Center; M.M. ter Wee, MSc, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location VU University Medical Center; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; A.M. van Sijl, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; Y.M. Smulders, Professor, Doctor, Department of Internal Medicine, VU University Medical Center; M.T. Nurmohamed, Professor, Doctor, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center. s.heslinga@reade.nl.
² From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade and VU University Medical Center; and Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands.S.C. Heslinga, MD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; M.J. Peters, MD, PhD, Department of Internal Medicine, VU University Medical Center; M.M. ter Wee, MSc, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location VU University Medical Center; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; A.M. van Sijl, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; Y.M. Smulders, Professor, Doctor, Department of Internal Medicine, VU University Medical Center; M.T. Nurmohamed, Professor, Doctor, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center.

PMID: 26329334
DOI: 10.3899/jrheum.150193

Abstract

Objective: To investigate the effects of changing inflammation on lipid levels in ankylosing spondylitis.

Methods: In a cohort of 230 patients, lipid levels were measured at baseline and after 52 weeks of treatment with tumor necrosis factor-α-blocking agents (anti-TNF).

Results: Total cholesterol (TC; +4.6%), low-density lipoprotein cholesterol (+4.3%), and high-density lipoprotein cholesterol (HDL-C; +3.7%) increased upon treatment. Changes were most evident in patients with substantial reduction in inflammatory levels (TC +8.2% vs +1.6% and HDL-C +8.3% vs +2.2% in patients with C-reactive protein ≥ 10 mg/l normalizing upon treatment vs CRP < 10 mg/l throughout treatment period).

Conclusion: Anti-TNF therapy results in lipid changes mostly when inflammation is appreciably modified.

Keywords: ANKYLOSING SPONDYLITIS; ANTI-TUMOR NECROSIS FACTOR THERAPY; CARDIOVASCULAR DISEASE; INFLAMMATION; LIPIDS.

MeSH terms

Adalimumab / therapeutic use*
Adult
C-Reactive Protein / metabolism*
Cholesterol, LDL / blood
Cholesterol, LDL / drug effects*
Cohort Studies
Dose-Response Relationship, Drug
Drug Administration Schedule
Etanercept / therapeutic use*
Female
Follow-Up Studies
Humans
Inflammation / drug therapy
Inflammation / prevention & control*
Injections, Subcutaneous
Linear Models
Lipids / blood
Male
Middle Aged
Severity of Illness Index
Spondylitis, Ankylosing / blood
Spondylitis, Ankylosing / drug therapy*
Treatment Outcome

Substances

Cholesterol, LDL
Lipids
C-Reactive Protein
Adalimumab
Etanercept