Castro Karla R, Aikawa Nádia E, Saad Carla Gonçalves, Moraes Júlio C B, Medeiros Ana C, Mota Licia Maria H, Silva Clovis A A, Bonfá Eloísa, Carvalho Jozélio F
Rheumatology Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Clin Dev Immunol. 2011;2011:352686. doi: 10.1155/2011/352686. Epub 2011 Jul 24.
To evaluate lipid profile changes after anti-TNF therapy in patients with psoriatic arthritis (PsA).
Fifteen PsA patients (eight polyarticular, four oligoarticular, two axial, and one mutilating) under infliximab were included. None had dyslipoproteinemia or previous statin use. Total cholesterol (TC) and its fractions, inflammatory markers, and prednisone use were evaluated.
The comparisons of lipid levels between baseline and after three months (3M) of anti-TNF therapy showed that there was a significant increase in mean triglycerides (117.8 ± 49.7 versus 140.1 ± 64.1 mg/dL, P = 0.028) and VLDL-c (23.6 ± 10.5 versus 28.4 ± 13.7 mg/dL, P = 0.019) levels. In contrast, there were no differences in the mean TC (P = 0.28), LDL-c (P = 0.42), and HDL-c (P = 0.26) levels. Analysis of the frequencies of each lipid alteration at baseline and at 3M were alike (P > 0.05). Positive correlations were found between VLDL-c and CRP (r = 0.647, P = 0.009) and between triglycerides and CRP (r = 0.604, P = 0.017) levels at 3M. ESR reduction was observed after 3M (P = 0.04). Mean prednisone dose remained stable at beginning and at 3M (P = 0.37).
This study demonstrated that anti-TNF may increase TG and VLDL-c levels in PsA patients after three months.
评估银屑病关节炎（PsA）患者接受抗TNF治疗后的血脂变化情况。
纳入15例接受英夫利昔单抗治疗的PsA患者（8例多关节型、4例少关节型、2例中轴型和1例毁形性）。所有患者均无血脂异常或既往他汀类药物使用史。评估总胆固醇（TC）及其组分、炎症标志物和泼尼松使用情况。
抗TNF治疗3个月（3M）前后血脂水平比较显示，平均甘油三酯（117.8±49.7对140.1±64.1mg/dL，P=0.028）和极低密度脂蛋白胆固醇（VLDL-c）（23.6±10.5对28.4±13.7mg/dL，P=0.019）水平显著升高。相比之下，平均TC（P=0.28）、低密度脂蛋白胆固醇（LDL-c）（P=0.42）和高密度脂蛋白胆固醇（HDL-c）（P=0.26）水平无差异。基线和3M时各血脂改变频率分析相似（P>0.05）。3M时，VLDL-c与CRP（r=0.647，P=0.009）以及甘油三酯与CRP（r=0.604，P=0.017）水平之间呈正相关。3M后观察到血沉降低（P=0.04）。平均泼尼松剂量在开始时和3M时保持稳定（P=0.37）。
本研究表明，抗TNF治疗3个月后可能会使PsA患者的TG和VLDL-c水平升高。
