AB0578 Tocilizumab influence on the serum lipid profiles and rapid progression of intima media-thickness in patients with rheumatoid arthritis

Background Rheumatoid arthritis (RA) is characterized by a high risk of cardiovascular events (CVE) associated with atherosclerosis (AS). A key role in the development of AS belongs to rheumatoid inflammation. Influence of biologic therapy on the cardiovascular system is not enough studied. Objectives to assess the of tocilizumab (TCZ) therapy on lipid profile and carotid intima-media thickness (cIMT) in RA patients (pts). Methods 43 RA pts with moderate/good effect (EULAR) of TCZ therapy, mean age 51 (43;55) years, disease duration - 56 (23;81) months were included in the study. Cardiovascular disease has 26/43 RA pts: arterial hypertension - 23 (52%), ischemic heart disease – 5 (12%) pts. All pts received TCZ 8 mg/kg intravenously every four week. Serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low- density lipoprotein cholesterol (LDL-C), the atherogenic index (AI): TC-HDL-C/HDL-C as well as disease activity score (DAS28), C-reactive protein (CRP), IgM RF, HAQ, cIMT were examined at baseline and after 24 weeks of TCZ treatment. Abnormal lipid levels were defined according to the European Society of Cardiology (ESC) guidelines as TC≥5,0mmol/l, LDL-C≥3,0 mmol/l, TG≥1,7mmol/l, HDL-C≤1,4mmol/l. The cIMT was evaluated by high resolution B-mode ultrasound. Results The dynamic of TC, LDL-C, HDL-C, TG levels on baseline and after 24 weeks TCZ treatment were 5.0 and 5.9mmol/l (Δ+11,6%); 3,4 and 3,1 mmol/l (Δ-1,6%) (p>0,05); 1,2 and 2,1 mmol/l (Δ+48,9%); 1,2 and 1,1 mmol/l (Δ-7,0%) accordingly; the AI was 3,2 at baseline and decreased to 2,0 (Δ-31,9%) (p