Ann Rheum Dis. 2015;0:1-7. doi:10.1136/annrheumdis-2015-207872 [Epub ahead of print]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.