title: Effects of repeated infliximab therapy on serum lipid profile in patients with refractory rheumatoid arthritis.
abstract: BACKGROUND
  Patients with rheumatoid arthritis (RA) frequently display an atherogenic lipid profile which has been linked with inflammation. Tumor necrosis factor-alpha (TNF-alpha), a pivotal pro-inflammatory cytokine in RA may be involved in the development of the disturbed lipid metabolism. We investigated whether infliximab, an anti-TNF-alpha therapy, may modify the lipid profile.
  
  
  METHODS
  56 consecutive RA patients were treated with infliximab (3 mg/kg at weeks 0, 2, 6, 14, 22, 30). Lipid profile and CRP were assayed at baseline and before infusion at weeks 6 and 30. Baseline values were compared with those in 56 healthy volunteers.
  
  
  RESULTS
  At baseline, the concentrations of HDL-cholesterol were lower in RA patients than in the controls (1.3+/-0.4 vs. 1.5+/-0.2 mmol/L; p<0.01). The triglyceride concentrations (1.6+/-0.8 vs. 1.3+/-0.4 mmol/L, p<0.01), the ratio of total cholesterol/HDL-cholesterol (4.3+/-1.6 vs. 3.2+/-0.5, p<0.001) and LDL-cholesterol/HDL-cholesterol (2.6+/-1.2 vs. 1.7+/-0.5, p<0.001) were significantly higher in RA patients than in controls. After 6 weeks of infliximab therapy, the mean total cholesterol concentration increased by 25% (p<0.001), LDL-cholesterol by 24% (p<0.001) and HDL-cholesterol by 30% (p<0.001). The decrease in CRP levels to 30 week inversely correlated with the increase in HDL-cholesterol (r=-0.47, p=0.005).
  
  
  CONCLUSIONS
  Infliximab administration is associated with important increases in cholesterol levels in all its forms but as no significant beneficial effect on the atherogenic ratio.
authors.affiliation: Department of Rheumatology A, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris 5 University, 75679 Paris Cedex 14, France.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Allanore
authors.forename: André
authors.initials: A
authors.lastname: Kahan
authors.forename: Jeremie
authors.initials: J
authors.lastname: Sellam
authors.forename: Ohvanesse G
authors.initials: OG
authors.lastname: Ekindjian
authors.forename: Didier
authors.initials: D
authors.lastname: Borderie
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000069285:Infliximab; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged
chemical_list: D000911:Antibodies, Monoclonal; D008055:Lipids; D000069285:Infliximab