Modifications of the lipid profile in the context of biological therapy with rituximab in patients with active rheumatoid arthritis

Introduction: Rheumatoid arthritis (RA) is associated with an increased cardiovascular risk, effect attributa-ble to the synergy between high inflammation, acce-leration of the atherosclerotic process and increased prevalence of traditional cardiovascular risk factors. Administration of Rituximab (RTX), an anti-CD20 monoclonal antibody, may have beneficial effects on cardiovascular risk, particularly by improving the lipid profile.
Objective: To evaluate the influence of RTX on cardi-ovascular risk factors, especially on lipid profile para-meters.
Methods: We performed a 52-week retrospective study on a group of 40 consecutive active PR patients, subop-timally controlled by classical synthetic remissions drugs and failure of an anti-TNF alpha agent, respec-ting the criteria of the national biological therapy proto-col. Patients received RTX cycles at 24 weeks, meaning 2 perfusions 1000 mg each, at 2 weeks. We evaluated demographic and anthropometric parameters, serum glucose levels, total cholesterol (TC), and HDL- and LDL-cholesterol fractions, triglycerides (TG), both at the onset and at the end of the study. We also evaluated the RA activity level and the therapeutic response by calculating the DAS28-VSH, CDAI, SDAI and EULAR scores to 26 and 52 weeks, respectively.
Results: We noticed the significant reduction of TG and CT levels after administering RTX, without signi-ficant modifications of the other parameters. We also revealed a direct proportionality relationship between the activity level of the disease/the good response to treatment and the improvement of the lipid profile.
Conclusions: The administration of RTX according to the protocol, over a 52-week period, in patients with ac-tive PR is associated with a decreased activity of the di-sease, correlated with a significant improvement in the lipid profile. Thus, the decrease in systemic inflammati-on is accompanied by a reduction in the atherosclerotic process, quantified by the decrease of TG and TC.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)