High-density Lipoprotein Profiling Changes in Patients with Rheumatoid Arthritis Treated with Tumor Necrosis Factor Inhibitors: A Cohort Study

2013 ◽  
Vol 40 (6) ◽  
pp. 825-830 ◽  
Author(s):  
Anna Jamnitski ◽  
Johannes H. Levels ◽  
Inge A. van den Oever ◽  
Michael T. Nurmohamed
Keyword(s):  
Rheumatoid Arthritis ◽  
Tumor Necrosis Factor ◽  
High Density Lipoprotein ◽  
Tumor Necrosis ◽  
Density Lipoprotein ◽  
High Density ◽  
Tnf Inhibitors ◽  
Eular Response ◽  
Amyloid A ◽  
Necrosis Factor

Objective.We investigated changes in high-density lipoprotein (HDL) profiling in patients with rheumatoid arthritis who started treatment by taking tumor necrosis factor (TNF) inhibitors. The patients were stratified for European League Against Rheumatism (EULAR) response.Methods.A group of 100 patients naive for TNF inhibitors at baseline were randomly selected from 204 adalimumab-treated and 203 etanercept-treated patients on the basis of their EULAR response. HDL profiling was measured using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry.Results.In EULAR good responders, mass charged markers representing serum amyloid A (SAA-1 and -2) decreased significantly after 4 months’ therapy. There were no significant differences in HDL profiling in EULAR nonresponders.Conclusion.Effective suppression of inflammation with TNF inhibitors results in favorable changes in HDL composition.

Anti-Ro/SSA Antibodies Are an Independent Factor Associated with an Insufficient Response to Tumor Necrosis Factor Inhibitors in Patients with Rheumatoid Arthritis

2011 ◽  
Vol 38 (11) ◽  
pp. 2346-2354 ◽  
Author(s):  
RAN MATSUDAIRA ◽  
NAOTO TAMURA ◽  
FUMIO SEKIYA ◽  
MICHIHIRO OGASAWARA ◽  
KENJIRO YAMANAKA ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Tumor Necrosis Factor ◽  
Clinical Response ◽  
Tumor Necrosis ◽  
Tnf Inhibitors ◽  
Multivariable Logistic Regression Analysis ◽  
Discontinuation Rate ◽  
Eular Response ◽  
Insufficient Response ◽  
Necrosis Factor

Objective.To study the significance of anti-Ro/SSA antibodies (anti-Ro) in the clinical response to tumor necrosis factor (TNF) inhibitors in patients with rheumatoid arthritis (RA).Methods.The clinical responses of a cohort of 190 patients with RA who were treated with infliximab, etanercept, or adalimumab (n = 112, 64, and 14, respectively) as the first biologics were examined using the Disease Activity Score in 28 joints (DAS28) at 24 weeks and the discontinuation rate at 56 weeks. The baseline characteristics of responders and the nonresponders were compared. The clinical response was compared between anti-Ro-negative and -positive patients. The factors associated with the inefficiency of TNF inhibitors were estimated with a multivariable logistic regression analysis.Results.The positive rate of anti-Ro was significantly higher in patients with no European League Against Rheumatism (EULAR) response at 24 weeks (OR 3.64, 95% CI 1.45–9.01, p = 0.003). In anti-Ro-positive patients, a moderate or good EULAR response rate was significantly lower with a sustaining higher median DAS28 (p = 0.006), and this difference was greater among infliximab-treated patients. The discontinuation rate for TNF inhibitors due to inefficacy at 56 weeks was also higher in anti-Ro-positive patients (OR 4.68, 95% CI 1.82–11.99, p = 0.0005), and 75% of these patients received infliximab. The presence of anti-Ro was strongly associated with no EULAR response at 24 weeks and a higher discontinuation rate of TNF inhibitors by 56 weeks (OR 5.22, 95% CI 1.75–15.57, p = 0.003 and OR 10.18, 95% CI 2.18–49.56, p = 0.003).Conclusion.The presence of anti-Ro might be related to the lesser clinical response to infliximab compared to other TNF inhibitors, suggesting that the presence of anti-Ro should be considered when choosing the appropriate biologics for patients with RA.

scholarly journals Επίδραση της επιμήκους γαστρεκτομής με ή χωρίς εκτομή του επιπλόου στην ευαισθησία στην ινσουλίνη, στην έκκριση των ορμονών του γαστρεντερικού και στα επίπεδα των λιποκυτταροκινών σε ασθενείς με σοβαρού βαθμού παχυσαρκία

2014 ◽  
Author(s):  
Ηλίας Σδράλης
Keyword(s):  
Tumor Necrosis Factor ◽  
High Density Lipoprotein ◽  
Tumor Necrosis ◽  
Tumor Necrosis Factor Α ◽  
Density Lipoprotein ◽  
High Density ◽  
Tnf Α ◽  
Hs Crp ◽  
Factor Α ◽  
Necrosis Factor

ΣΚΟΠΟΣ: Ο αυξηµένος σπλαχνικός λιπώδης ιστός αποτελεί σηµαντικό παράγοντακινδύνου για µεταβολικές επιπλοκές, που συσχετίζονται µε την παχυσαρκία, καιπροάγει µία ήπιου βαθµού χρόνια φλεγµονώδη διαδικασία. Το επίπλουν έχει απόκαιρό εµπλακεί στη, σχετιζόµενη µε την παχυσαρκία, µεταβολική δυσλειτουργία.Αυτό βασίζεται στη σηµαντική του λειτουργία, της έκκρισης αντιποκινών. Η ιδέα τηςεκτοµής του µείζονος επιπλόου, στον ίδιο χρόνο µε µία βαριατρική επέµβαση, έχειπροταθεί για την βελτίωση των µεταβολικών µεταβολών και την µεγιστοποίηση τηςαπώλειας βάρους. Ο σκοπός της συγκεκριµένης µελέτης ήταν να προσδιορίσει εάν ηεκτοµή του µείζονος επιπλόου, στον ίδιο χρόνο µε τη λαπαροσκοπική επιµήκηγαστρεκτοµή, έχει κάποια επίδραση στο µεταβολικό προφίλ, την έκκριση τωναντιποκινών, το στάτους της φλεγµονής και την απώλεια βάρους, σε βραχύ ή µακρόβάθος χρόνου.ΜΕΘΟΔΟΙ: Τριάντα – ένας παχύσαρκοι ασθενείς (Δείκτης Μάζας Σώµατος (ΒΜΙ):42.49±2.03 Kg/m2 ) τυχαιοποιήθηκαν σε δύο οµάδες, λαπαροσκοπικής επιµήκουςγαστρεκτοµής, µε ή χωρίς επιπλεκτοµή. Αντιπονεκτίνη, Οµεντίνη, Ιντερλευκίνη-6(IL-6), tumor necrosis factor-α ((TNF-α), C-αντιδρώσα πρωτεΐνη υψηλήςευαισθησίας (hs-CRP), high-density lipoprotein (HDL) χοληστερόλη, γλυκόζηνηστείας, ινσουλίνη και αντίσταση στην ινσουλίνη (εκτιµωµένη µε εφαρµογή Quickie Test) µετρήθηκαν και εκτιµήθηκαν προεγχειρητικά και 7 µέρες, 1, 3 και 12µήνες µετεγχειρητικά.ΑΠΟΤΕΛΕΣΜΑΤΑ: Κατά τη µετεγχειρητική παρακολούθηση, στη διάρκεια τουπρώτου χρόνου, ο δείκτης µάζας σώµατος µειώθηκε αξιοσηµείωτα και συγκριτικάκαι στις δύο οµάδες (Ρ<0.001). Τα επίπεδα της ινσουλίνης, IL-6 και hs-CRP,µειώθηκαν σηµαντικά σε σχέση µε τις τιµές αναφοράς (προεγχειρητικά) (Ρ<0.05) καιστις δύο οµάδες, χωρίς στατιστικά σηµαντική διαφορά µεταξύ τους. Τα επίπεδααντιπονεκτίνης και HDL αυξήθηκαν οµοίως και σηµαντικά, συγκρινόµενα µε ταεπίπεδα αναφοράς (Ρ<0.001) και στις δύο οµάδες. Τα επίπεδα της Οµεντίνηςαυξήθηκαν σηµαντικά (Ρ<0.05) στην οµάδα ελέγχου (επιµήκης γαστρεκτοµή, χωρίςεκτοµή του επιπλόου) και παρέµειναν χαµηλά στην οµάδα της επιπλεκτοµής(επιµήκης γαστρεκτοµή + επιπλεκτοµή), στο ένα έτος µετεγχειρητικά. Δεν υπήρξεστατιστικά σηµαντική διαφορά στη µεταβολή των επιπέδων TNF-α σε κάθε οµάδα.ΣΥΜΠΕΡΑΣΜΑΤΑ: Τα, µέχρι τώρα, θεωρητικά πλεονεκτήµατα της επιπλεκτοµής,όσον αφορά την απώλεια βάρους και το µεταβολικό σύνδροµο, δεναντικατοπτρίζονται στην προοπτική αυτή µελέτη. Επιπλέον, δοθέντος τουπροστατευτικού ρόλου της οµεντίνης σε συνδυασµό µε τη θετική συσχέτισηή της µετα επίπεδα αντιπονεκτίνης πλάσµατος και HDL, ήδη γνωστώνκαρδιοπροστατευτικών πρωτεϊνών, ανακύπτουν ερωτήµατα γύρω από την αρνητικήεπίδραση της επιπλεκτοµής και καρδιαγγειακής φυσιολογίας, σε βάθος χρόνου

scholarly journals Changing Patterns of Tumor Necrosis Factor Inhibitor Use in 9074 Patients with Rheumatoid Arthritis

2009 ◽  
Vol 36 (5) ◽  
pp. 907-913 ◽  
Author(s):  
YUSUF YAZICI ◽  
SVETLANA KRASNOKUTSKY ◽  
JAIME P. BARNES ◽  
PATRICIA L. HINES ◽  
JASON WANG ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Tumor Necrosis Factor ◽  
Dose Escalation ◽  
Tumor Necrosis ◽  
Randomized Clinical Trials ◽  
Tnf Inhibitors ◽  
Tnf Inhibitor ◽  
Insurance Claims ◽  
Claims Database ◽  
Necrosis Factor

Objective.Patients with rheumatoid arthritis (RA) commonly switch between tumor necrosis factor (TNF) inhibitors after failing to control disease activity. Much of the clinical data that support switching to a second TNF agent when one agent fails to work has come from small, short-term studies. We utilized a US insurance claims database to determine patterns of use such as dose escalation, time to discontinuation, and switching between TNF inhibitors in patients with RA.Methods.A retrospective analysis was performed using an insurance claims database in the US from 2000 to 2005. TNF inhibitor use, time to switch, dose escalation, and continuation times were analyzed in patients with RA.Results.Nine thousand seventy-four patients with RA started TNF inhibitors during the period 2000 to 2005. Etanercept was the most commonly used TNF inhibitor; infliximab had the highest duration of continuation, about 50% at 2 years. In addition, infliximab showed higher rates of dose escalation compared to etanercept and adalimumab. For all TNF inhibitors, time to switching decreased from 2000 to 2005.Conclusion.TNF inhibitor use patterns changed from 2000 to 2005, with more frequent changes among the different TNF inhibitors and a shorter duration of treatment before the change. Only about 50% of TNF inhibitors are still continued at 2 years, reflecting the difference between randomized clinical trials and real-world experience.

Tumor Necrosis Factor-α Inhibitor Use Is Not Associated with Lipid Changes in Rheumatoid Arthritis

2012 ◽  
Vol 39 (5) ◽  
pp. 946-948 ◽  
Author(s):  
ANDRONIKI BILI ◽  
STEPHANIE J. MORRIS ◽  
JENNIFER A. SARTORIUS ◽  
H. LES KIRCHNER ◽  
JANA L. ANTOHE ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Tumor Necrosis Factor ◽  
Tumor Necrosis ◽  
Tumor Necrosis Factor Α ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Levels ◽  
Tnf Α ◽  
Factor Α ◽  
Necrosis Factor

Objective.To determine the association of use of tumor necrosis factor-α (TNF-α) inhibitors with differences in lipid levels in patients with rheumatoid arthritis (RA).Methods.We studied 807 patients with incident RA to compare differences in lipid levels in TNF-α inhibitor users versus nonusers, with adjustment for relevant covariables.Results.TNF-α inhibitor use was not associated with differences in levels of low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), triglycerides, LDL:HDL, or TC:HDL compared to nonusers.Conclusion.Use of TNF-α inhibitor was not associated with differences in lipid levels in patients with RA.

Severe Extraarticular Manifestations in a Community-based Cohort of Patients with Rheumatoid Arthritis: Risk Factors and Incidence in Relation to Treatment with Tumor Necrosis Factor Inhibitors

2017 ◽  
Vol 44 (7) ◽  
pp. 981-987 ◽  
Author(s):  
Lisa Theander ◽  
Britt-Marie Nyhäll-Wåhlin ◽  
Jan-Åke Nilsson ◽  
Minna Willim ◽  
Lennart T.H. Jacobsson ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Tumor Necrosis Factor ◽  
Tumor Necrosis ◽  
Tnf Inhibitors ◽  
Time Dependent ◽  
Community Based ◽  
Rheumatoid Arthritis Risk ◽  
Increased Risk ◽  
Clinical Records ◽  
Necrosis Factor

Objective.The aims of this study were to evaluate whether treatment with tumor necrosis factor (TNF) inhibitors in patients with rheumatoid arthritis (RA) affects the risk of developing severe extraarticular rheumatoid arthritis (ExRA) manifestations and to investigate potential predictors for developing ExRA.Methods.A dynamic community-based cohort of patients with RA was studied (n = 1977). Clinical records were reviewed and cases of severe ExRA were identified. Information on exposure to TNF inhibitors was obtained from a regional register. Exposure to TNF inhibitors was analyzed in a time-dependent fashion and the incidence of severe ExRA in exposed patients was compared with the incidence in unexposed patients. Cox regression models were used to assess potential predictors of severe ExRA.Results.During treatment with TNF inhibitors, there were 17 patients with new onset of severe ExRA in 2400 person-years at risk (PY; 0.71/100 PY, 95% CI 0.41–1.13) compared with 104 in 15,599 PY (0.67/100 PY, 95% CI 0.54–0.81) in patients without TNF inhibitors. This corresponded to an incidence rate ratio of 1.06 (95% CI 0.60–1.78). The age- and sex-adjusted HR for ExRA in anti-TNF–treated patients was 1.21 (95% CI 1.02–1.43), with similar findings in models adjusted for time-dependent Health Assessment Questionnaire and propensity for anti-TNF treatment. Male sex, positive rheumatoid factor (RF), long disease duration, and greater disability were predictors for ExRA.Conclusion.This study suggests that patients treated with TNF inhibitors are at a slightly increased risk of developing severe ExRA. RF-positive patients with disabling disease of long duration were more likely to develop severe ExRA.

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