Reduction of Inflammation Drives Lipid Changes in Ankylosing Spondylitis

Objective. To investigate the effects of changing inflammation on lipid levels in ankylosing spondylitis. Methods. In a cohort of 230 patients, lipid levels were measured at baseline and after 52 weeks of treatment with tumor necrosis factor-alpha-blocking agents (anti-TNF). Results. Total cholesterol (TC; +4.6%), low-density lipoprotein cholesterol (+4.3%), and high-density lipoprotein cholesterol (HDL-C; +3.7%) increased upon treatment. Changes were most evident in patients with substantial reduction in inflammatory levels (TC +8.2% vs +1.6% and HDL-C +8.3% vs +2.2% in patients with C-reactive protein = 10 mg/l normalizing upon treatment vs CRP < 10 mg/l throughout treatment period). Conclusion. Anti-TNF therapy results in lipid changes mostly when inflammation is appreciably modified.