Reduction of Inflammation Drives Lipid Changes in Ankylosing Spondylitis.
OBJECTIVE
To investigate the effects of changing inflammation on lipid levels in ankylosing spondylitis.


METHODS
In a cohort of 230 patients, lipid levels were measured at baseline and after 52 weeks of treatment with tumor necrosis factor-α-blocking agents (anti-TNF).


RESULTS
Total cholesterol (TC; +4.6%), low-density lipoprotein cholesterol (+4.3%), and high-density lipoprotein cholesterol (HDL-C; +3.7%) increased upon treatment. Changes were most evident in patients with substantial reduction in inflammatory levels (TC +8.2% vs +1.6% and HDL-C +8.3% vs +2.2% in patients with C-reactive protein ≥ 10 mg/l normalizing upon treatment vs CRP < 10 mg/l throughout treatment period).


CONCLUSIONS
Anti-TNF therapy results in lipid changes mostly when inflammation is appreciably modified.
From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade and VU University Medical Center; and Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands.S.C. Heslinga, MD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; M.J. Peters, MD, PhD, Department of Internal Medicine, VU University Medical Center; M.M. ter Wee, MSc, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location VU University Medical Center; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; A.M. van Sijl, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; Y.M. Smulders, Professor, Doctor, Department of Internal Medicine, VU University Medical Center; M.T. Nurmohamed, Professor, Doctor, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center. s.heslinga@reade.nl.
Sjoerd C
SC
Heslinga
From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade and VU University Medical Center; and Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands.S.C. Heslinga, MD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; M.J. Peters, MD, PhD, Department of Internal Medicine, VU University Medical Center; M.M. ter Wee, MSc, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location VU University Medical Center; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; A.M. van Sijl, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; Y.M. Smulders, Professor, Doctor, Department of Internal Medicine, VU University Medical Center; M.T. Nurmohamed, Professor, Doctor, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center.
Mike J
MJ
Peters
From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade and VU University Medical Center; and Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands.S.C. Heslinga, MD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; M.J. Peters, MD, PhD, Department of Internal Medicine, VU University Medical Center; M.M. ter Wee, MSc, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location VU University Medical Center; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; A.M. van Sijl, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; Y.M. Smulders, Professor, Doctor, Department of Internal Medicine, VU University Medical Center; M.T. Nurmohamed, Professor, Doctor, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center.
Marieke M
MM
Ter Wee
From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade and VU University Medical Center; and Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands.S.C. Heslinga, MD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; M.J. Peters, MD, PhD, Department of Internal Medicine, VU University Medical Center; M.M. ter Wee, MSc, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location VU University Medical Center; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; A.M. van Sijl, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; Y.M. Smulders, Professor, Doctor, Department of Internal Medicine, VU University Medical Center; M.T. Nurmohamed, Professor, Doctor, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center.
Irene E
IE
van der Horst-Bruinsma
From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade and VU University Medical Center; and Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands.S.C. Heslinga, MD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; M.J. Peters, MD, PhD, Department of Internal Medicine, VU University Medical Center; M.M. ter Wee, MSc, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location VU University Medical Center; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; A.M. van Sijl, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; Y.M. Smulders, Professor, Doctor, Department of Internal Medicine, VU University Medical Center; M.T. Nurmohamed, Professor, Doctor, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center.
Alper M
AM
van Sijl
From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade and VU University Medical Center; and Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands.S.C. Heslinga, MD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; M.J. Peters, MD, PhD, Department of Internal Medicine, VU University Medical Center; M.M. ter Wee, MSc, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location VU University Medical Center; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; A.M. van Sijl, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; Y.M. Smulders, Professor, Doctor, Department of Internal Medicine, VU University Medical Center; M.T. Nurmohamed, Professor, Doctor, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center.
Yvo M
YM
Smulders
From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade and VU University Medical Center; and Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands.S.C. Heslinga, MD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; M.J. Peters, MD, PhD, Department of Internal Medicine, VU University Medical Center; M.M. ter Wee, MSc, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location VU University Medical Center; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; A.M. van Sijl, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; Y.M. Smulders, Professor, Doctor, Department of Internal Medicine, VU University Medical Center; M.T. Nurmohamed, Professor, Doctor, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center.
Michael T
MT
Nurmohamed
D000068879:Adalimumab / Q000627:therapeutic use*; D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism*; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects*; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D000068800:Etanercept / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000188:drug therapy / Q000517:prevention & control*; D007279:Injections, Subcutaneous; D016014:Linear Models; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013167:Spondylitis, Ankylosing / Q000097:blood / Q000188:drug therapy*; D016896:Treatment Outcome
D008078:Cholesterol, LDL; D008055:Lipids; D002097:C-Reactive Protein; D000068879:Adalimumab; D000068800:Etanercept
ANKYLOSING SPONDYLITIS; ANTI-TUMOR NECROSIS FACTOR THERAPY; CARDIOVASCULAR DISEASE; INFLAMMATION; LIPIDS