TNF Inhibitor Improves CV Risk in Patients with Psoriatic Arthritis

Long-term use of etanercept (ETN) is associated with small changes in lipid metabolism, reduced levels of inflammation, and, in turn, improved cardiovascular (CV) risk in patients with psoriatic arthritis (PsA), according to a recent study.

For their study, the researchers evaluated an observational cohort of 118 patients with PsA. The long-term effects of ETN therapy on CV risk factors were assessed via mixed-model analyses.
_______________________________________________________________________________________________________

RELATED CONTENT
PsA Treatment Provides Modest Benefits to Lesions, Musculoskeletal Symptoms
Depression Reduces Likelihood of Remission in RA, PsA Patients
_______________________________________________________________________________________________________

Results indicated that ETN use was associated with decreases in Disease Activity Score in 28 joints, C-reactive protein levels, and erythrocyte sedimentation rates during therapy. Although participants demonstrated an increase in total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol, the total cholesterol/high-density lipoprotein ratio remained unaltered, and the apolipoprotein B to apolipoprotein A-I (apoB/apoA-I) ratio decreased significantly. An increase in CRP levels was found to be associated with an increase in the apoB/apoA-1 ratio.

“Serum lipid concentrations showed small changes over a 5-year period of ETN therapy and were inversely associated with inflammatory markers,” the researchers concluded. “Other CVD risk factors remained stable. The apoB/apoA-1 ratio decreased over time and an increase in disease activity was associated with an increase in this ratio. However, this modest lipid modulation cannot explain the observed beneficial CV effects of ETN, and ETN likely exerts those effects through inflammation-related mechanisms.”

—Christina Vogt

Reference:

Agca R, Heslinga M, Kneepkens EL, van Dongen C, Nurmohamed MT. The effects of 5-year etanercept therapy on cardiovascular risk factors in patients with psoriatic arthritis. J Rheumatol. 2017;44(9):1362-1368. https://doi.org/10.3899/jrheum.161418.