Rheumatoid arthritis patients are potentially at higher risk to develop cardiovascular risk, but studies have shown reverse correlation of lipids and RA with different opinion. What is actual relationship and if lipids are low, how Statin helps in RA?
I think RA associate with increase LDL-C ( bad cholesterol) and TG, as well as decrease HDL-C which so called good cholesterol. In general, the end stage of RA is reach the heart muscle then lead to death if not treated.
Respected Dr Abdulsamie, its not true. Dyslipidemia in RA is characterized by decreased serum concentration of total cholesterol and cholesterol in LDL and HDL fractions and thats why its called paradoxical association or reverse epidemiological association.
The question is whether dyslipidemia improves with DMARDs? I mean to say is there will be any change of lipid parameters with improvement of disease activity (DAS Score)?
I agree with Drs. Cocco and Padina. In terms of cardioprotection, hydroxychloroquine (HCQ or Plaquenil) may be be a good addition to the treatment regimen of patients with RA and lupus; it can lower lipids modestly, decrease glycemia some, and act as a blood thinner of sorts,
The reason statins have been successful in treating cardiovascular disease is not so much because they lower cholesterol, which they do of course, but rather because they are primarily anti-inflammatory agents. Here, endothelial dysfunction and atherosclerosis have an inflammatory basis. The early lesion of the so-called "fatty streak" has no fat at all; it contains lymphocyte aggregates; there is plenty of data in this regard in terms of the anti-inflammatory effects of the statins that has been generated over the years,
Although generally DMARDs and TNFi do not affect the lipid profile, tocilizumab and tofacitinib do adversely affect the lipid profile. But whether this effect is significant, or whether the anti-inflammatory effect is more important, is not known. So the whether the CV risk is increased for those 2 agents is unknown. Below is a recent review:
Arthritis Rheumatol. 2015 Jan;67(1):117-27. doi: 10.1002/art.38894.
Lipid profile changes in patients with chronic inflammatory arthritis treated with biologic agents and tofacitinib in randomized clinical trials: a systematic review and meta-analysis.
Souto A1, Salgado E, Maneiro JR, Mera A, Carmona L, Gómez-Reino JJ.
http://www.ncbi.nlm.nih.gov/pubmed/25303044
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