The Effects of 5-year Etanercept Therapy on Cardiovascular Risk Factors in Patients with Psoriatic Arthritis.

Rabia Agca, Maaike Heslinga, Eva L Kneepkens, Carlo van Dongen, Michael T Nurmohamed

Journal: The Journal of rheumatology 2018;44(9):1362-1368

PMID: 28572461

Abstract

OBJECTIVE

To investigate the effects of etanercept (ETN) on lipid metabolism and other known cardiovascular disease (CVD) risk factors in patients with psoriatic arthritis (PsA).

METHODS

In an observational cohort of 118 consecutive patients with PsA, CVD risk factors were assessed over 5 years. Mixed-model analyses were performed to investigate the effects of ETN therapy on CVD risk factors over time.

RESULTS

Disease Activity Score in 28 joints, C-reactive protein (CRP), and erythrocyte sedimentation rate decreased during therapy with ETN. There was an increase in total cholesterol (TC), high-density lipoprotein cholesterol (HDLc), and low-density lipoprotein cholesterol. The TC/HDLc ratio remained unaltered. The apolipoprotein B to apolipoprotein A-I (apoB/apoA-I) ratio decreased significantly. An increase in CRP was associated with an increase in the apoB/apoA-1 ratio.

CONCLUSION

Serum lipid concentrations showed small changes over a 5-year period of ETN therapy and were inversely associated with inflammatory markers. Other CVD risk factors remained stable. The apoB/apoA-1 ratio decreased over time and an increase in disease activity was associated with an increase in this ratio. However, this modest lipid modulation cannot explain the observed beneficial CV effects of ETN, and ETN likely exerts those effects through inflammation-related mechanisms.

Address: From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center | VU University Medical Center, Amsterdam, the Netherlands.; R. Agca, MD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center | VU University Medical Center; M. Heslinga, MD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center | VU University Medical Center; E.L. Kneepkens, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center| Reade; C. van Dongen, MD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center| Reade; M.T. Nurmohamed, MD, Professor, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center | VU University Medical Center.; From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center | VU University Medical Center, Amsterdam, the Netherlands. [email protected].; R. Agca, MD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center | VU University Medical Center; M. Heslinga, MD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center | VU University Medical Center; E.L. Kneepkens, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center| Reade; C. van Dongen, MD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center| Reade; M.T. Nurmohamed, MD, Professor, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center | VU University Medical Center. [email protected].

DOI: 10.3899/jrheum.161418

Link outs

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Medical:

https://medlineplus.gov/psoriaticarthritis.html

Other Literature Sources:

https://scite.ai/reports/28572461

Miscellaneous:

https://assays.cancer.gov/CPTAC-652

Research Materials:

https://antibodies.cancer.gov/detail/CPTC-CRP-1

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MeSH Terms: Aged, Antirheumatic Agents, Arthritis, Psoriatic, Biomarkers, Cardiovascular Diseases, Etanercept, Female, Humans, Lipids, Male, Middle Aged, Risk Factors