Moderate Changes in Lipids With Tocilizumab/Tofacitinib in RA

Review shows no changes for rheumatoid arthritis patients with tumor necrosis factor antagonist tx

FRIDAY, Jan. 23, 2015 (HealthDay News) -- For patients with rheumatoid arthritis (RA), moderate changes in lipids are observed after treatment with tocilizumab or tofacitinib, according to a review published in the January issue of Arthritis & Rheumatology.

Alejandro Souto, M.D., from the Complejo Hospitalario Universitario de Santiago de Compostela in Spain, and colleagues conducted a systematic review of the literature and performed meta-analyses to examine lipid changes in patients with RA and spondyloarthritis (SpA) treated with biological agents or tofacitinib. Data were obtained from 25 articles reporting on randomized controlled trials.

The researchers found that tocilizumab-treated RA patients were more likely to have hypercholesterolemia (odds ratio, 4.64), increased levels of high-density lipoprotein (HDL) cholesterol (odds ratio, 2.25), and increased levels of low-density lipoprotein (LDL) cholesterol (odds ratio, 4.80), compared with placebo-treated patients. These correlations were not seen in patients treated with tumor necrosis factor antagonists or tofacitinib. The mean percentage of increase in the HDL and LDL cholesterol levels was higher among patients receiving tofacitinib 5 mg twice daily (weighted mean difference [WMD], 13.00 and 11.20 mg/dL, respectively) and those receiving tofacitinib 10 mg twice daily (WMD, 15.21 and 15.42 mg/dL, respectively), compared with those in the comparator groups. There were no data available for treatment of RA with other biologic agents or for SpA.

"Whether these changes pertain to the control of inflammation or to the mechanism of action of the biologic agents or tofacitinib remains undetermined," the authors write.

Two authors disclosed financial ties to pharmaceutical companies, including Pfizer, which partially funded the study.

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