Comparison of lipid and lipid-associated cardiovascular risk marker changes after treatment with tocilizumab or adalimumab in patients with rheumatoid arthritis
RA patients have increased risk of CVD compared with the general population that is not fully explained by traditional risk factors. This is a post-hoc analysis of data from a clinical trial that compared IL-6 and TNF-α signaling inhibition to compare changes in lipids and lipid-associated CV risk markers in 324 patients treated with TCZ IV q4w or ADA SC q2w for 24 weeks. HDL-SAA and sPLA2 IIA is also measured in an additional subpopulation of 87 and 97 TCZ and ADA patients, respectively.
Greater increases in LDL-C, HDL-C, TC, triglycerides, and TC:HDL ratio were seen with TCZ from baseline to 8 weeks. HDL-SAA, sPLA2 IAA, and Lp(a) were shown to decrease more with TCZ than ADA. Similar results were observed between ACR and EULAR responders and non-responders.
Lipid change effects of IL-6 and TNF-α inhibition do not have synonymous manifestations in net impact on lipids and lipoproteins. The clinical significance of this is unclear and requires further study.