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High HDL cholesterol levels cardioprotective in tofacitinib-treated RA patients

10 May 2019

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.

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Most Read Articles
12 Aug 2019
Treatment with nebivolol yields more favourable changes in 24-hour, intradialytic and daytime systolic and diastolic blood pressure variability in patients with intradialytic hypertension, a study has found.
Stephen Padilla, 25 Jul 2019
Nonvitamin K antagonist oral anticoagulants (NOACs) appear to confer more clinical benefits to elderly patients with atrial fibrillation (AF) than vitamin K antagonist anticoagulants (VKAs), suggests a study, adding that this is primarily driven by the lower rates of major bleeding.
11 Aug 2019
Intraoperative methylprednisolone does not appear to significantly prevent the incidence of death, cardiac arrest and other injuries in neonates undergoing cardiac surgery with cardiopulmonary bypass, according to a recent study.
25 Jul 2019
Adding a third drug to achieve the target blood pressure (BP) seems to be more effective than increasing the dose of existing dual therapy without any increase in adverse events, suggest the results of a meta-analysis, adding that early use of triple therapy can help improve hypertension control.