Karimifar Mansoor, Sepehrifar Mohammad S, Moussavi Hamidreza, Sepehrifar Mohammad B, Mottaghi Peyman, Siavash Mansour, Karimifar Mozhgan
Department of Rheumatology, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Internal Medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2018 Dec 28;23:105. doi: 10.4103/jrms.JRMS_869_17. eCollection 2018.
Rheumatoid arthritis (RA) is a common chronic autoimmune disorder that leads to damage of human joints. There are various treatment approaches in which different drugs are prescribed which have several alterations in serum lipids. This research aimed to study the effect of RA treatments on the serum lipids.
Two hundred randomly selected patients with RA were randomly assigned to three different groups. The first group of patients was treated with a combination of prednisolone (PRD) and hydroxychloroquine (HCQ). The second group was treated with three drugs including PRD, HCQ, and methotrexate (MTX). The third group was treated with four medications including PRD, HCQ, MTX, and sulfasalazine. Within each group, the lipid factors such as triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), and high-density lipoprotein (HDL), erythrocyte sedimentation rate, and visual analog scale were measured at the beginning of the experiment and 6 months after exposing the treatments. For each group, we also calculated the Disease Activity Score-28 (DAS-28). The analysis of variance revealed that the overall DAS-28 was significantly different among the three groups.
In the first group, the level of TG and TC significantly decreased ( = 0.015 and ≤ 0.001, respectively). In the second group, the level of TG and LDL significantly decreased ( = 0.009). In the third group, the LDL level increased considerably ( < 0.001). The HDL level significantly increased in all three groups ( = 0.012, = 0.014, and = 0.028, respectively).
The treatment PRD + HCQ + MTX was more effective in reducing the LDL level and increasing the HDL level. To reduce the risk of cardiovascular diseases in patients with RA, it is important to prescribe the combination of drugs which leads and normalizes the lipid profile levels.
类风湿性关节炎（RA）是一种常见的慢性自身免疫性疾病，会导致人体关节损伤。有多种治疗方法，会开具不同药物，这些药物会使血脂发生多种变化。本研究旨在探讨类风湿性关节炎治疗对血脂的影响。
随机选取200例类风湿性关节炎患者，随机分为三组。第一组患者接受泼尼松龙（PRD）和羟氯喹（HCQ）联合治疗。第二组接受三种药物治疗，包括PRD、HCQ和甲氨蝶呤（MTX）。第三组接受四种药物治疗，包括PRD、HCQ、MTX和柳氮磺胺吡啶。在每组中，于实验开始时及治疗6个月后测量血脂因子，如甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白（LDL）和高密度脂蛋白（HDL）、红细胞沉降率以及视觉模拟评分。对于每组，我们还计算了疾病活动评分-28（DAS-28）。方差分析显示，三组之间的总体DAS-28存在显著差异。
在第一组中，TG和TC水平显著降低（分别为 = 0.015和 ≤ 0.001）。在第二组中，TG和LDL水平显著降低（ = 0.009）。在第三组中，LDL水平显著升高（ < 0.001）。所有三组的HDL水平均显著升高（分别为 = 0.012、 = 0.014和 = 0.028）。
PRD + HCQ + MTX治疗在降低LDL水平和提高HDL水平方面更有效。为降低类风湿性关节炎患者患心血管疾病的风险，开具能使血脂谱水平正常化的联合药物很重要。
