Effects of cytotoxic T-lymphocyte-associated protein 4 compared to TNF inhibitors on lipid profile: Results from an observational multicentre rheumatoid arthritis cohort

Autoimmun Rev. 2024 Feb;23(2):103478. doi: 10.1016/j.autrev.2023.103478. Epub 2023 Nov 11.

Abstract

Aim: To evaluate the impact of selective cytotoxic T-lymphocyte-associated protein 4 (CTLA-4Ig) compared to tumor necrosis factor inhibitors (TNFi) on cardiovascular (CV) clinical and laboratory outcomes in patients with rheumatoid arthritis (RA).

Methods: We performed a prospective observational multicenter study of RA patients included in the "Cardiovascular Obesity and Rheumatic DISease (CORDIS)" Study Group database, collecting demographic, clinical, and laboratory data of those starting a CTLA-4Ig or TNFi at baseline, 6-month, and 12-month follow-up.

Results: Of the 206 RA patients without previous CV events enrolled in the study, 64 received a CTLA-4Ig and 142 a TNFi. The two groups did not differ in age, gender, or smoking habits, and the prevalence of hypertension, diabetes, and metabolic syndrome was similar. Over a follow-up period of 12 months, although no significant differences were found in the disease activity course, we observed that LDL cholesterol levels slightly decreased only in the CTLA-4Ig-treated patients.

Conclusions: Patients treated with both CTLA-4Ig and TNFi did not differ in disease activity response and changes in traditional CV risk factors after 12 months of treatment. However, CTL-A-4Ig treatment is associated with a favorable change in lipid profile at 12-month follow-up.

Keywords: CTLA-4Ig; Cardiovascular risk factors; TNFi.

Publication types

  • Multicenter Study
  • Observational Study
  • Comparative Study
  • Letter

MeSH terms

  • Abatacept / therapeutic use
  • Adult
  • Aged
  • Antirheumatic Agents / pharmacology
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid* / drug therapy
  • CTLA-4 Antigen* / antagonists & inhibitors
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology
  • Female
  • Humans
  • Lipids / blood
  • Male
  • Middle Aged
  • Prospective Studies
  • Tumor Necrosis Factor Inhibitors / therapeutic use
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

  • CTLA-4 Antigen
  • Tumor Necrosis Factor Inhibitors
  • Antirheumatic Agents
  • Lipids
  • Tumor Necrosis Factor-alpha
  • Abatacept