HDL cholesterol levels may predict CV risk in tofacitinib-treated RA patients
medwireNews: Increasing levels of high-density lipoprotein (HDL) cholesterol are associated with a reduction in cardiovascular (CV) risk among rheumatoid arthritis (RA) patients undergoing treatment with the Janus kinase (JAK) inhibitor tofacitinib, researchers report.
In their post-hoc analysis – including data from six phase III ORAL trials of tofacitinib and two long-term extension studies – Koshika Soma (Pfizer Inc, Groton, Connecticut, USA) and team found that 1.27% of 4076 participants experienced independently adjudicated major adverse cardiovascular events (MACE; myocardial infarction, cerebrovascular event, or cardiovascular death) over 12,932 person–years of tofacitinib exposure, giving an incidence rate of 0.4 patients with events per 100 person–years.
After adjustment for factors including age and tofacitinib dose, increasing levels of HDL cholesterol over 24 weeks of treatment with the JAK inhibitor were associated with a significantly reduced risk for future MACE. Low-density lipoprotein and total cholesterol levels were not associated with MACE risk, however.
The study authors also report that age at intake, history of hypertension, and the ratio of total to HDL cholesterol at baseline were significantly associated with future MACE risk, “reinforcing that traditional CV risk factors are important to CV risk in patients with RA.”
They conclude in Arthritis & Rheumatology that their findings “could be beneficial in future profiling of tofacitinib-treated patients with RA who may be at greatest risk of MACE.”
By Claire Barnard
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