Lipid Paradox in Rheumatoid Arthritis: Changes With Rheumatoid Arthritis Therapies
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Rheumatoid arthritis (RA) is associated with increased cardiovascular (CV) morbidity and mortality, related not only to traditional CV risk factors, but also to a chronic inflammatory state. However, lipid profiles in RA are different from those observed in the general population at risk of CV disease, where there is evidence of a positive relationship between disease and high cholesterol levels. In untreated patients with active RA this relationship is different, with a paradoxical effect resulting in lower levels of cholesterol associated with an increased risk of CV disease. In this review, we summarize the latest evidence on lipid abnormalities in the setting of RA and the interaction between inflammation and lipoproteins, as well as the effect of DMARDs and biologic therapies on lipid profiles and the possible implications for CV outcomes in this population.
KeywordsRheumatoid arthritis Lipids Cardiovascular risk Markers of inflammation Paradox Therapy Risk factors Lipid profiles Atherosclerosis
Dr. Suarez-Almazor is the recipient of a K24 award from the National Institute on Arthritis, Musculoskeletal and Skin Disorders (NIAMS K24AR053593). The article’s contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIAMS or NIH.
No potential conflicts of interest relevant to this article were reported.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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