RT Journal Article
SR Electronic
T1 Anti-inflammatory treatment improves high-density lipoprotein function in rheumatoid arthritis
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 766
OP 773
DO 10.1136/heartjnl-2015-308953
VO 103
IS 10
A1 Francis O'Neill
A1 Marietta Charakida
A1 Eric Topham
A1 Eve McLoughlin
A1 Neha Patel
A1 Emma Sutill
A1 Christopher W M Kay
A1 Francesco D'Aiuto
A1 Ulf Landmesser
A1 Peter C Taylor
A1 John Deanfield
YR 2017
UL http://heart.bmj.com/content/103/10/766.abstract
AB Objective Patients with rheumatoid arthritis (RA) are at increased cardiovascular risk. Recent studies suggest that high-density lipoprotein (HDL) may lose its protective vascular phenotype in inflammatory conditions. However, the effects of common anti-inflammatory treatments on HDL function are not yet known.Methods We compared the function of HDL in 18 patients with RA and 18 matched healthy controls. Subsequently, patients were randomised to (methotrexate+infliximab (M+I) (5 mg/kg)) or methotrexate+placebo (M+P) infusions for 54 weeks. At week 54 and thereafter, all patients received infliximab therapy until completion of the trial (110 weeks), enabling assessment of the impact of 1 year of infliximab therapy in all patients. HDL functional properties were assessed at baseline, 54 weeks and 110 weeks by measuring the impact on endothelial nitric oxide (NO) bioavailability and superoxide production (SO), paraoxonase activity (PON-1) and cholesterol efflux.Results All HDL vascular assays were impaired in patients compared with controls. After 54 weeks, NO in response to HDL was significantly greater in patients who received M+I compared with those who received M+P. Endothelial SO in response to HDL was reduced in both groups, but PON-1 and cholesterol efflux remained unchanged. All vascular measures improved compared with baseline after ≥1 infliximab therapy in the analysis at 110 weeks. No significant trend was noted for cholesterol efflux.Conclusions HDL function can be improved with anti-inflammatory treatment in patients with RA. The M+I combination was superior to the M+P alone, suggesting that the tumour necrosis factor-α pathway may have a role in HDL vascular properties.