title: Effects of tofacitinib and other DMARDs on lipid profiles in rheumatoid arthritis: implications for the rheumatologist.
abstract: Cardiovascular (CV) morbidity and mortality are increased in patients with active, untreated rheumatoid arthritis (RA), despite lower levels of total and low-density lipoprotein cholesterol reported in individuals with active RA compared with those without RA. Alterations in non-traditional lipid assessments, such as high-density lipoprotein (HDL) function and HDL-associated proteins, have been described in patients with active RA, including elevated HDL-associated serum amyloid A and decreased paraoxonase-1 activity. We review changes in both traditional lipoprotein concentrations and non-traditional lipoprotein assessments in multiple studies of treatment with disease-modifying antirheumatic drugs (DMARDs), including non-biologic and biologic DMARDs and tofacitinib. In addition, data from a recently published clinical trial with tofacitinib that describe a potential mechanism for suppression of cholesterol levels in active RA patients are reviewed. Finally, CV event data from various studies of DMARDs are presented, and the current management of RA patients with regard to the CV risk is reviewed.
authors.affiliation: University of California, Los Angeles, CA. Electronic address: CCharles@mednet.ucla.edu.
authors.forename: Christina
authors.initials: C
authors.lastname: Charles-Schoeman
authors.affiliation: Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Gonzalez-Gay
authors.affiliation: Pfizer Inc., Groton, CT.
authors.forename: Irina
authors.initials: I
authors.lastname: Kaplan
authors.affiliation: Pfizer Inc., Groton, CT.
authors.forename: Mary
authors.initials: M
authors.lastname: Boy
authors.affiliation: Pfizer Inc., New York, NY.
authors.forename: Jamie
authors.initials: J
authors.lastname: Geier
authors.affiliation: Pfizer Inc., Shanghai, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Luo
authors.affiliation: Pfizer Inc., Groton, CT.
authors.forename: Andrea
authors.initials: A
authors.lastname: Zuckerman
authors.affiliation: Pfizer Inc., Groton, CT.
authors.forename: Richard
authors.initials: R
authors.lastname: Riese
mesh_terms: D018501:Antirheumatic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000188:drug therapy; D006801:Humans; D008055:Lipids / Q000097:blood*; D010880:Piperidines / Q000008:administration & dosage* / Q000627:therapeutic use; D011743:Pyrimidines / Q000008:administration & dosage* / Q000627:therapeutic use; D011758:Pyrroles / Q000008:administration & dosage* / Q000627:therapeutic use; D012219:Rheumatology
chemical_list: D018501:Antirheumatic Agents; D008055:Lipids; D010880:Piperidines; D011743:Pyrimidines; D011758:Pyrroles; C479163:tofacitinib
keywords: Disease-modifying antirheumatic drugs; Janus kinase; Rheumatoid arthritis; TNF inhibitors; Tofacitinib