5-year etanercept therapy provides positive CV effects in PsA patients
Etanercept therapy for a period of 5 years leads to small changes in serum lipid concentrations, which are inversely correlated with inflammatory markers, according to a recent study. Other cardiovascular disease (CVD) risk factors remain stable.
Furthermore, there is a significant decrease in the apolipoprotein B to apolipoprotein A-I (apoB/apoA-I) ratio over time, and an increase in disease activity is more likely to result in an increase in this ratio.
Researchers examined the effects of etanercept on lipid metabolism and other known CVD risk factors in patients with psoriatic arthritis (PsA). They recruited a total of 118 consecutive patients, in whom CVD risk factors were evaluated over 5 years. Mixed model analyses were conducted to determine the effects of etanercept therapy over time.
Etanercept reduced Disease Activity Score in 28 joints, C-reactive protein (CRP) and erythrocyte sedimentation rate during therapy. An increase was observed in total cholesterol, high-density lipoprotein (HDL) cholesterol and low-density lipoprotein cholesterol. The total cholesterol/HDL cholesterol ratio remained the same.
The apoB/apoA-I ratio decreased significantly. An increase in CRP correlated with an increase in the apoB/apoA-1 ratio.
“However, this modest lipid modulation cannot explain the observed beneficial CV effects of etanercept, and etanercept likely exerts those effects through inflammation-related mechanisms,” researchers said.
Randomized placebo-controlled trials and observational studies representing routine clinical studies have shown the efficacy of etanercept in PsA. The study drug inhibited radiographic disease progression at 1 and 2 years. Also, etanercept can be used either in monotherapy or in combination with disease-modifying antirheumatic drugs such as methotrexate. [J Rheumatol Suppl 2012;89:74-6]
Etanercept is an antitumour necrosis factor (TNF)-α agent used in rheumatoid arthritis and PsA. [Clin Exp Immunol 2014;177:234-43]