High HDL cholesterol levels cardioprotective in tofacitinib-treated RA patients
Increases in levels of high-density lipoprotein (HDL-C) but not low-density lipoprotein (LDL-C) or total cholesterol (TC) after 24 weeks of tofacitinib treatment translate to a lower risk of future major adverse cardiovascular events (MACEs), according to a study.
Researchers conducted a posthoc analysis of six phase III trials and two long‐term extension studies over 7 years involving patients with moderately to severely active RA receiving ≥1 tofacitinib dose. Cox regression models were used to evaluate associations between baseline variables and time to first MACE following 24 weeks of tofacitinib initiation.
A total of 52 MACEs occurred over 12,873 patient‐years of exposure, with an incidence rate of 0.4 patient with events/100 patient‐years.
In univariable analyses of baseline variables, traditional cardiovascular risk factors, as well as use of corticosteroid and statin, emerged as risk factors for MACE risk in RA. No such associations were obtained for disease activity and inflammation measures.
In subsequent multivariable analyses, baseline age, hypertension and TC/HDL‐C remained significantly associated with the risk of MACE. Conversely, HDL‐C increases and TC/HDL‐C decreases after 24 weeks of tofacitinib treatment conferred a protective benefit. Changes in TC, LDL‐C and disease activity measures had no effect on MACE risk.
Finally, erythrocyte sedimentation rate increases trended with increased future MACE risk.
Researchers stressed the need for more data to further evaluate the cardiovascular safety of tofacitinib for RA.