Lipoprotein(A) Concentrations In Rheumatoid Arthritis On Biologic Therapy: Results From The Cardiovascular In Rheumatology [Carma] Study Project

• Published in: Journal of clinical lipidology Vol. 11; no. 3; pp. 749 - 756.e3
• Main Authors: García-Gómez, Carmen, MD, PhD, Martín-Martínez, Maria A., MD, Castañeda, Santos, MD, PhD, Sanchez-Alonso, Fernando, MD, Uriarte-Ecenarro, Miren, MD, González-Juanatey, Carlos, MD, PhD, Romera-Baures, Montserrat, MD, PhD, Santos-Rey, José, MD, Pinto-Tasende, José Antonio, MD, PhD, Quesada-Masachs, Estefanía, MD, Tornero-Molina, Jesús, MD, PhD, Martínez-González, Olga, MD, PhD, Cobo-Ibáñez, Tatiana, MD, PhD, Chamizo-Carmona, Eugenio, MD, Manrique-Arija, Sara, MD, PhD, Fábregas-Canales, Dolores, MD, Díaz-González, Federico, MD, PhD, Llorca, Javier, MD, PhD, González-Gay, Miguel A., MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2017
• Subjects: Adult; Arthritis, Rheumatoid - blood; Arthritis, Rheumatoid - therapy; Biological Therapy; Biologics; Cardiovascular; Cardiovascular disease; Cross-Sectional Studies; Female; Humans; Lipoprotein(a); Lipoprotein(a) - blood; Male; Middle Aged; Rheumatoid arthritis; Risk; Tocilizumab; IHD; CARMA; Apolipoprotein AI; ischemic heart disease; CARdiovascular in rheumatology; TNF; ACPA; Lp(a); Health Assessment Questionnaire; tocilizumab; apo(a); angiotensin converting enzyme; C-reactive protein: CRP; atherogenic index; apoB100; Erythrocyte sedimentation rate; Disease Activity Score including 28 joints and erythrocyte sedimentation rate; biologics; Apolipoprotein (a); body mass index; Total cholesterol: TC; Triglycerides: TG; IL-6; RA; DAS28-ESR; angiotensin II receptor blockers; Anti-cyclic citrullinated peptide antibodies; High-density lipoprotein cholesterol: HDL-c; Rheumatoid arthritis; disease-modifying antirheumatic drugs; apolipoprotein B; Spanish Society of Rheumatology: SER; standard deviation; Cardiovascular; NSAID; apo B; TCZ; Apolipoprotein B100; apo AI; Low-density lipoprotein cholesterol; Interleukin-6; SD; BMI; cardiovascular disease; ACE; LDL-c; ESR; TC/HDL-c; DMARD; non-steroidal anti-inflammatory drugs; CV; tumor necrosis factor; HAQ; Rheumatoid factor RF; ARBs; lipoprotein(a); Cardiovascular disease; Lipoprotein(a); Tocilizumab; Biologics
• ISSN: 1933-2874; 1876-4789
• DOI: 10.1016/j.jacl.2017.02.018

Abstract Background Plasma concentrations of lipoprotein (a) [Lp(a)], a lipoprotein with atherogenic and thrombogenic properties, have a strong genetic basis, although high concentrations of Lp(a) have also been reported in the context of inflammation, as in rheumatoid arthritis (RA). Few studies evaluate the impact of biologic therapies (BT) on Lp(a) in RA, taking into account that with these new therapies a better control of inflammation is achieved. Objective Evaluate the plasma concentrations of Lp(a) in Spanish RA patients on BT attending rheumatology outpatient clinics. Methods Baseline analysis of the CARMA project, a 10-year prospective study evaluating the risk of cardiovascular events in RA and other forms of inflammatory arthritis. RA patients were classified according to treatment: no biologic, anti-tumor necrosis factor, anti-IL-6 receptor tocilizumab (TCZ), and other biologic (rituximab or abatacept). A model of linear multivariate regression was built in which the dependent variable was Lp(a) concentration and the explanatory variable was BT. The model was adjusted for confounding factors. Results Seven hundred and seventy-five RA patients were analyzed. Plasma concentrations of total cholesterol and triglyceride were significantly higher in TCZ-treated patients. Nevertheless, no significant difference in the atherogenic index between TCZ-treated patients and patients without BT was found. After adjusting for confounding factors, patients with BT had lower concentrations of Lp(a) than those without BT; however, only TCZ-treated patients achieved statistically significant differences (β: -0.303, 95% CI: -0.558 to -0.047; p=0.02). Conclusions RA patients treated with tocilizumab show lower plasma concentrations of Lp(a) compared to patients without BT.