ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 0900

Effect of Biologic Agents on Lipid Levels and Cardiovascular Risk in Rheumatoid Arthritis Patients

Dimitrios Pappas1, Jon Giles2, George Reed3, Kevin Kane4, Jeffrey Curtis5 and Joel Kremer6, 1CorEvitas, LLC, Waltham, MA, 2Columbia University, New York, NY, 3The Corrona Research Foundation and University of Massachusetts, Albany, NY, 4University of Massachusetts, Worcester, MA, 5University of Alabama at Birmingham, Hoover, AL, 6The Corrona Research Foundation, Delray Beach, FL

Meeting: ACR Convergence 2022

Keywords: Biologicals, Cardiovascular, rheumatoid arthritis, risk assessment

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Sunday, November 13, 2022

Title: RA – Diagnosis, Manifestations, and Outcomes Poster II

Session Type: Poster Session B

Session Time: 9:00AM-10:30AM

Background/Purpose: Cardiovascular (CV) risk in RA is increased due to interaction between traditional risk factors and systemic inflammation. The purpose of this analysis was to investigate the effect of biologic DMARDs on lipid levels and cardiovascular risk and evaluate whether such effect is associated with changes in CRP and disease activity measures. In addition, we evaluated whether patients with lower LDL levels experience larger increases in LDL which are tracking with disease improvement after initiation of a biologic.

Methods: Patients (pts) with at least moderate disease activity (CDAI >10) initiating a biologic DMARD enrolled in the CERTAIN comparative effectiveness study nested within CorEvitas (formerly known as Corrona) RA registry. Characteristics, including lipid values, and Reynolds Risk Score (RRS) in pts initiating a TNF-α inhibitor (TNFi) or non‐TNFi (rituximab [RTX], abatacept [ABT] or tocilizumab [TCZ]), were measured at baseline prior to biologic initiation and at 3 and 6 months later. Longitudinal mixed models examined the association of individual biologics with changes in lipid levels, and Reynolds Risk Score (RRS). Structural equation models were utilized to model mediation of CRP, CDAI or swollen joint count on lipid changes. Patients who interrupted therapy prior to follow up visits or without complete lipid data were excluded. Change in LDL at 6 months among patients with low LDL at baseline (≤90mg/dl) vs patients in groups with higher levels (90-130 and ≥130mg/dl) were compared. The association between LDL change across baseline LDL groups and disease activity improvement was evaluated.

Results: 1698 initiations of a biologic were analyzed. At baseline 36.8% of pts were biologic naïve and 24.5% on anti-hyperlipidemic therapy. History of prior CVD was present in 7.9% of pts. Pts initiating TCZ had a significant increase in lipid levels but RRS at 3 and 6 months was similar across all biologics (table 1). Mediator analyses were statistically significant regarding the CRP effect (table 2). LDL changes differed depending on baseline LDL but were consistent with estimated changes due to regression to the mean. An association between LDL improvement and CRP change was similar for all baseline LDL groups (table 3).

Conclusion: The impact of lipid changes on CVD risk must be considered in the context of the burden of inflammation in pts with RA. Lipid increases may not necessarily be atherogenic and may occur in the context of the “lipid paradox”. In this analysis, moderate increases in lipid levels did not translate to an increased CVD risk as captured by RRS and were partially associated with CRP changes.

Supporting image 1

Table 1. Baseline lipid levels, log hsCRP and Reynolds Risk Score and adjusted effect of individual biologics at 3 and 6 months after initiating biologic therapy(a)

Supporting image 2

Table 2: Mediator analysis of CRP effect on lipids for TCZ vs other biologics after 3 and 6 months of therapy(a)

Supporting image 3

Table 3. LDL evolution in relation to disease activity improvement and associations with CDAI and CRP change(a)


Disclosures: D. Pappas, CorEvitas, Novartis, Sanofi, Genentech, Roche, AbbVie; J. Giles, Pfizer, Eli Lilly, AbbVie/Abbott, Bristol-Myers Squibb(BMS), Novartis, Gilead; G. Reed, CorEvitas, Corrona Research Foundation; K. Kane, None; J. Curtis, AbbVie/Abbott, Amgen, ArthritisPower, Aqtual, Bendcare, Bristol-Myers Squibb(BMS), CorEvitas, FASTER, GlaxoSmithKlein(GSK), IlluminationHealth, Janssen, Labcorp, Eli Lilly, Myriad, Novartis, Pfizer, Sanofi, Scipher, Setpoint, UCB, United Rheumatology; J. Kremer, CorEvitas.

To cite this abstract in AMA style:

Pappas D, Giles J, Reed G, Kane K, Curtis J, Kremer J. Effect of Biologic Agents on Lipid Levels and Cardiovascular Risk in Rheumatoid Arthritis Patients [abstract]. Arthritis Rheumatol. 2022; 74 (suppl 9). https://acrabstracts.org/abstract/effect-of-biologic-agents-on-lipid-levels-and-cardiovascular-risk-in-rheumatoid-arthritis-patients/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to ACR Convergence 2022

ACR Meeting Abstracts - https://acrabstracts.org/abstract/effect-of-biologic-agents-on-lipid-levels-and-cardiovascular-risk-in-rheumatoid-arthritis-patients/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology