Background Biological drugs (BD) for autoimmune inflammatory disease (AID) treatment are associated with increased lipids in many studies.
Patients with AID have an increased cardiovascular risk comparable with that of diabetes mellitus patients, and need tight control.
Purpose To determine the prevalence of hypercholesterolaemia (HP) in patients with AID treated with BD compared with the general population. To study whether there are differences between the diseases or between BD. To assess if hypercholesterolaemic patients are properly treated.
Material and methods A cross sectional study was performed. All patients treated with BD between January and May 2015 in a secondary hospital were included.
Demographic variables, diagnostics, BD and other drugs, lipid profile, glucose, CRP and ESR were collected from the electronic medical history. LDL and HDL data were available in 11.19% of patients, so the study was based on the values of total cholesterol. Patients without laboratory data during the study period were excluded.
Hypercholesterolaemia was considered: patients with total cholesterol ≥200 mg/dL or lipid lowering therapy.
Reference was made to Erice study where 46.7% of the Spanish population had high cholesterol.
Statistical analysis was performed with the Stata/IC 13.1 program.
Results 344 patients were taking BD, of whom 286 were included in the study. Mean age was 50.6 (14.5) years and 51.4% were men.
HP was significantly higher (55.14%, 95% CI 48.48 to 61.80%) in AID treated with BD than in the general population, excluding Crohn´s disease patients where it was significantly lower (29.17%, 95% CI 18.67 to 39.67%).
Analysed by treatment, HP was higher for all drugs than in the general population although statistical significance was only reached for tocilizumab (80%, 95% CI 55.21 to 104.79%)
High cholesterol values were presented for 90 patients but 64 (71%) had no lipid lowering therapy.
Conclusion The guidelines for use of lipid lowering agents recommend treatment with statins for patients with a high cardiovascular risk and increased lipids.
In our study, HP was higher in patients with biological treatment than in the Spanish population, mainly tocilizumab treated, and surprisingly most did not have LDL and HDL levels and only 29% were taking statins.
Pharmacist should monitor the hypercholesterolaemic effect of BD and warn of the need for treatment as in most patients this is going unnoticed.
References and/or Acknowledgements
Rev Esp Cardiol 2008;61: 1030-40. doi:10/1016/j.autrev.2010.07.08
References and/or AcknowledgementsNo conflict of interest.
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