title: Modifications in lipid levels are independent of serum TNF-α in rheumatoid arthritis: results of an observational 24-week cohort study comparing patients receiving etanercept plus methotrexate or methotrexate as monotherapy.
abstract: OBJECTIVE
  To compare the modifications in lipids between patients with rheumatoid arthritis (RA) receiving etanercept plus methotrexate (ETA + MTX) versus methotrexate (MTX) and their relationship with serum levels of tumor necrosis factor-alpha (TNF-α).
  
  
  METHODS
  In an observational cohort study, we compared changes in lipid levels in patients receiving ETA + MTX versus MTX in RA. These groups were assessed at baseline and at 4 and 24 weeks, measuring clinical outcomes, total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, and TNF-α.
  
  
  RESULTS
  Baseline values for lipid levels were similar in both groups. HDL-C levels increased significantly only in the ETA + MTX group (from 45.5 to 50.0 mg/dL at 4 weeks, a 10.2% increase, P < 0.001, and to 56.0 mg/dL at 24 weeks, a 25.1% increase, P < 0.001), while other lipids underwent no significant changes. ETA + MTX also exhibited a significant increase in TNF-α (44.8 pg/mL at baseline versus 281.4 pg/mL at 24 weeks, P < 0.001). The MTX group had no significant changes in lipids or TNF-α. Significant differences in HDL-C between groups were observed at 24 weeks (P = 0.04) and also in TNF-α  (P = 0.01).
  
  
  CONCLUSIONS
  HDL-C levels increased significantly following treatment with ETA + MTX, without a relationship with decrease of TNF-α.
authors.affiliation: Programa de Doctorado en Farmacologia, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (U de G), Guadalajara, JAL, Mexico.
authors.forename: Norma Alejandra
authors.initials: NA
authors.lastname: Rodriguez-Jimenez
authors.affiliation: Hospital de Especialidades, Centro Medico Nacional de Occidente, Instituto Mexicano del Seguro Social (IMSS), Guadalajara, JAL, Mexico.
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Garcia-Gonzalez
authors.affiliation: Departamento de Anestesiología, Hospital Regional de Zona 1, IMSS, Aguascalientes, AGS, Mexico.
authors.forename: Karina Patricia
authors.initials: KP
authors.lastname: Ayala-Lopez
authors.affiliation: Centro Universitario de Investigaciones Biomédicas, Universidad de Colima, Colima, COL, Mexico.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Trujillo-Hernandez
authors.affiliation: Hospital de Especialidades, Centro Medico Nacional de Occidente, Instituto Mexicano del Seguro Social (IMSS), Guadalajara, JAL, Mexico ; Programa de Becarios en Investigacion en Salud, Unidad de Medicina Familiar 2, IMSS, Guadalajara, JAL, Mexico.
authors.forename: Erika Anita
authors.initials: EA
authors.lastname: Aguilar-Chavez
authors.affiliation: Programa de Doctorado en Farmacologia, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (U de G), Guadalajara, JAL, Mexico.
authors.forename: Alberto Daniel
authors.initials: AD
authors.lastname: Rocha-Muñoz
authors.affiliation: Centro Universitario de Investigaciones Biomédicas, Universidad de Colima, Colima, COL, Mexico.
authors.forename: Jose Clemente
authors.initials: JC
authors.lastname: Vasquez-Jimenez
authors.affiliation: Departamento de Anestesiología, Hospital General Regional 180, IMSS, Tlajomulco, JAL, Mexico.
authors.forename: Eva
authors.initials: E
authors.lastname: Olivas-Flores
authors.affiliation: Division de Investigacion en Salud, UMAE, Hospital de Especialidades, Centro Medico Nacional de Occidente, IMSS, Mexico.
authors.forename: Mario
authors.initials: M
authors.lastname: Salazar-Paramo
authors.affiliation: Departamento de Fisiologia, CUCS, U de G, Guadalajara, JAL, Mexico.
authors.forename: Esther Guadalupe
authors.initials: EG
authors.lastname: Corona-Sanchez
authors.affiliation: Coordinacion de Posgrado, CUCS, U de G, Guadalajara, JAL, Mexico.
authors.forename: Monica
authors.initials: M
authors.lastname: Vazquez-Del Mercado
authors.affiliation: Departamento de Patologia Clinica, Hospital General Regional 110, IMSS, Guadalajara, JAL, Mexico.
authors.forename: Evangelina
authors.initials: E
authors.lastname: Varon-Villalpando
authors.affiliation: Hospital de Especialidades, Centro Medico Nacional de Occidente, Instituto Mexicano del Seguro Social (IMSS), Guadalajara, JAL, Mexico.
authors.forename: Adolfo
authors.initials: A
authors.lastname: Cota-Sanchez
authors.affiliation: Programa de Doctorado en Farmacologia, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (U de G), Guadalajara, JAL, Mexico.
authors.forename: Ernesto German
authors.initials: EG
authors.lastname: Cardona-Muñoz
authors.affiliation: Unidad de Investigacion en Epidemiologia Clinica, Hospital de Especialidades, Centro Medico Nacional de Occidente, IMSS, Guadalajara, JAL, Mexico.
authors.forename: Jorge I
authors.initials: JI
authors.lastname: Gamez-Nava
authors.affiliation: Departamento de Medicina Interna-Reumatologia, Hospital General Regional 110, IMSS, 44716 Guadalajara, JAL, Mexico ; Programa de Doctorado en Salud Publica, CUCS, U de G, 44340 Guadalajara, JAL, Mexico.
authors.forename: Laura
authors.initials: L
authors.lastname: Gonzalez-Lopez
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D004359:Drug Therapy, Combination; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D008055:Lipids; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept; D008727:Methotrexate