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Effects of Tocilizumab, an Anti-Interleukin-6 Receptor Antibody, on Serum Lipid and Adipokine Levels in Patients with Rheumatoid Arthritis

Author

Hoffman E1,2,3, Rahat MA4,5, Feld J6, Elias M7, Rosner I8,9, Kaly L10, Lavie I11,12, Gazitt T13, Zisman D14,15. Int J Mol Sci. 2019 Sep 18;20(18). pii: E4633. doi: 10.3390/ijms20184633.

Author Information

1 Rheumatology Unit, Carmel Medical Center, Haifa 3436212, Israel. elinoard@gmail.com.

2 The Immunotherapy Laboratory, Carmel Medical Center, Haifa 3436212, Israel. elinoard@gmail.com.

3 The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa 3109601, Israel. elinoard@gmail.com.

4 The Immunotherapy Laboratory, Carmel Medical Center, Haifa 3436212, Israel. mrahat@netvision.net.il.

5 The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa 3109601, Israel. mrahat@netvision.net.il.

6 Rheumatology Unit, Carmel Medical Center, Haifa 3436212, Israel. joyfeld@gmail.com.

7 Rheumatology Unit, Carmel Medical Center, Haifa 3436212, Israel. MUNAEL@clalit.org.il.

8 The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa 3109601, Israel. itzhak.rosner@b-zion.org.il.

9 Rheumatology Unit, Bnai Zion Medical Center, Haifa, 3339419, Israel. itzhak.rosner@b-zion.org.il.

10 Rheumatology Unit, Bnai Zion Medical Center, Haifa, 3339419, Israel. lisakaly@yahoo.fr.

11 The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa 3109601, Israel. lavi_idit@clalit.org.il.

12 Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa 3436212, Israel. lavi_idit@clalit.org.il.

13 Rheumatology Unit, Carmel Medical Center, Haifa 3436212, Israel. tgazitt@gmail.com.

14 Rheumatology Unit, Carmel Medical Center, Haifa 3436212, Israel. devyzisman@gmail.com.

15 The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa 3109601, Israel. devyzisman@gmail.com.

Abstract

Patients with rheumatoid arthritis (RA) are at increased risk of cardiovascular disease. Dyslipidemia is a known adverse effect of tocilizumab (TCZ), an anti-interleukin-6 receptor antibody used in RA treatment. We aimed to assess the effect of TCZ on lipid profile and adipokine levels in RA patients. Height, weight, disease activity scores, lipid profile and atherogenic indices (AI), leptin, adiponectin, resistin, interleukin-6, and high-sensitivity C-reactive protein (CRP) were measured before and four months after initiation of TCZ in 40 RA patients and 40 healthy controls. Following TCZ treatment, total cholesterol, high density lipoprotein (HDL), and triglycerides were significantly elevated, but no significant changes in weight, body mass index (BMI), low density lipoprotein (LDL), and AI were observed. Compared with controls, significantly higher adiponectin levels were measured in the RA group at baseline. Following TCZ treatment, resistin levels and the leptin-to-adiponectin ratio increased, adiponectin levels decreased, and leptin levels remained unchanged. No correlation was found between the change in adipokine serum levels and changes in the disease activity indices, nor the lipid profile. In conclusion, the changes observed suggest a protective role for TCZ on the metabolic and cardiovascular burden associated with RA, but does not provide a mechanistic explanation for this phenomenon.