Effects of cytotoxic T-lymphocyte-associated protein 4 compared to TNF inhibitors on lipid profile: Results from an observational multicentre rheumatoid arthritis cohort.

Fabiola Atzeni, Fabio Cacciapaglia, James Galloways, Andreina Manfredi, Garifallia Sakellariou, Sam Norton, Elisa Gremese, Francesca Romana Spinelli, Ombretta Viapiana, Matteo Piga, Gian Luca Erre, Elena Bartoloni Bocci

Journal: Autoimmunity reviews 2024;23(2):103478

PMID: 37956778

Full Text on Elsevier Science View on PubMed

Abstract

AIM

To evaluate the impact of selective cytotoxic T-lymphocyte-associated protein 4 (CTLA-4Ig) compared to tumor necrosis factor inhibitors (TNFi) on cardiovascular (CV) clinical and laboratory outcomes in patients with rheumatoid arthritis (RA).

METHODS

We performed a prospective observational multicenter study of RA patients included in the "Cardiovascular Obesity and Rheumatic DISease (CORDIS)" Study Group database, collecting demographic, clinical, and laboratory data of those starting a CTLA-4Ig or TNFi at baseline, 6-month, and 12-month follow-up.

RESULTS

Of the 206 RA patients without previous CV events enrolled in the study, 64 received a CTLA-4Ig and 142 a TNFi. The two groups did not differ in age, gender, or smoking habits, and the prevalence of hypertension, diabetes, and metabolic syndrome was similar. Over a follow-up period of 12 months, although no significant differences were found in the disease activity course, we observed that LDL cholesterol levels slightly decreased only in the CTLA-4Ig-treated patients.

CONCLUSIONS

Patients treated with both CTLA-4Ig and TNFi did not differ in disease activity response and changes in traditional CV risk factors after 12 months of treatment. However, CTL-A-4Ig treatment is associated with a favorable change in lipid profile at 12-month follow-up.

Address: Rheumatology Unit, University of Messina, Messina, Italy. Electronic address: [email protected].; Rheumatology Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari, Bari, Italy.; Centre for Rheumatic Diseases, King's College London, London, UK.; Rheumatology Unit, Azienda Ospedaliera Universitaria Policlinico of Modena, Italy.; Department of Internal Medicine and Therapeutics, University of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.; Division of Clinical Immunology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore-Rome, 00168 Rome, Italy.; Rheumatology Unit, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Science, Sapienza University of Rome, Rome, Italy.; UOC Reumatologia, Università degli Studi di Verona, Italy.; Dipartimento Scienze Mediche e Sanità Pubblica, Università di Cagliari, Italy.; Dipartimento di Medicina, Chirurgia e Farmacia, Università degli Studi di Sassari, Italy.; Rheumatology Unit, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.

DOI: 10.1016/j.autrev.2023.103478

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MeSH Terms: Humans, Arthritis, Rheumatoid, Male, Female, Middle Aged, Prospective Studies, CTLA-4 Antigen, Aged, Tumor Necrosis Factor Inhibitors, Antirheumatic Agents, Lipids, Cardiovascular Diseases, Tumor Necrosis Factor-alpha, Abatacept, Adult