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Improvement of High-Density Lipoprotein Function in Patients With Early Rheumatoid Arthritis Treated With

Christina Charles-Schoeman1, Yuen Yin Lee1, Ani Shahbazian1

  • 1University of California, Los Angeles.

Arthritis & Rheumatology (Hoboken, N.J.)
|August 3, 2016
PubMed

Insights

Rheumatoid arthritis (RA) treatment improves high-density lipoprotein (HDL) function, reducing cardiovascular disease risk. Lowering RA disease activity enhances HDL

Area of Science:

  • Rheumatology
  • Cardiovascular Medicine
  • Biochemistry

Background:

  • Abnormal high-density lipoprotein (HDL) function is linked to increased cardiovascular (CV) disease incidence in rheumatoid arthritis (RA) patients.
  • The Treatment of Early Aggressive Rheumatoid Arthritis (TEAR) trial investigated RA treatment effects on HDL function.

Purpose of the Study:

  • To evaluate changes in HDL function and HDL-associated proteins over two years in early RA patients.
  • To assess the impact of different RA treatment regimens (monotherapy, combination, triple therapy) on HDL function.

Main Methods:

  • Measured HDL antioxidant capacity, paraoxonase 1 (PON-1) activity, and levels of HDL-associated haptoglobin (Hp), apolipoprotein A-I (Apo A-I), and myeloperoxidase (MPO) in 550 TEAR participants.
  • Utilized mixed-effects linear models to analyze changes in HDL parameters over 4 time points (baseline, 24, 48, 102 weeks).
  • Controlled for traditional CV risk factors, treatment regimen, prednisone, and statin use.

Main Results:

  • Decreased RA disease activity correlated with improved HDL function over time.
  • Specifically, reduced disease activity was associated with increased PON-1 activity and HDL-associated Apo A-I levels.
  • Improvements were also observed in the HDL inflammatory index, with decreased MPO and HDL-associated Hp levels.

Conclusions:

  • RA treatment, including methotrexate (MTX) monotherapy, MTX+etanercept (ETN), or MTX+sulfasalazine (SSZ)+hydroxychloroquine (HCQ) triple therapy, improves HDL function profile.
  • Abnormal HDL function may be a mechanism and therapeutic target for CV risk in RA patients.
  • Further research is warranted to confirm HDL function as a therapeutic target for cardiovascular risk in RA.
Abstract

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