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BioMed Research International
Volume 2014, Article ID 510305, 10 pages
Clinical Study

Modifications in Lipid Levels Are Independent of Serum TNF-α in Rheumatoid Arthritis: Results of an Observational 24-Week Cohort Study Comparing Patients Receiving Etanercept Plus Methotrexate or Methotrexate as Monotherapy

1Programa de Doctorado en Farmacologia, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (U de G), Guadalajara, JAL, Mexico
2Hospital de Especialidades, Centro Medico Nacional de Occidente, Instituto Mexicano del Seguro Social (IMSS), Guadalajara, JAL, Mexico
3Departamento de Anestesiología, Hospital Regional de Zona 1, IMSS, Aguascalientes, AGS, Mexico
4Centro Universitario de Investigaciones Biomédicas, Universidad de Colima, Colima, COL, Mexico
5Programa de Becarios en Investigacion en Salud, Unidad de Medicina Familiar 2, IMSS, Guadalajara, JAL, Mexico
6Departamento de Anestesiología, Hospital General Regional 180, IMSS, Tlajomulco, JAL, Mexico
7Division de Investigacion en Salud, UMAE, Hospital de Especialidades, Centro Medico Nacional de Occidente, IMSS, Mexico
8Departamento de Fisiologia, CUCS, U de G, Guadalajara, JAL, Mexico
9Coordinacion de Posgrado, CUCS, U de G, Guadalajara, JAL, Mexico
10Departamento de Patologia Clinica, Hospital General Regional 110, IMSS, Guadalajara, JAL, Mexico
11Unidad de Investigacion en Epidemiologia Clinica, Hospital de Especialidades, Centro Medico Nacional de Occidente, IMSS, Guadalajara, JAL, Mexico
12Departamento de Medicina Interna-Reumatologia, Hospital General Regional 110, IMSS, 44716 Guadalajara, JAL, Mexico
13Programa de Doctorado en Salud Publica, CUCS, U de G, 44340 Guadalajara, JAL, Mexico

Received 15 May 2014; Revised 9 July 2014; Accepted 9 July 2014; Published 27 August 2014

Academic Editor: Miguel A. Gonzalez-Gay

Copyright © 2014 Norma Alejandra Rodriguez-Jimenez et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To compare the modifications in lipids between patients with rheumatoid arthritis (RA) receiving etanercept plus methotrexate (ETA + MTX) versus methotrexate (MTX) and their relationship with serum levels of tumor necrosis factor-alpha (TNF-α). Methods. In an observational cohort study, we compared changes in lipid levels in patients receiving ETA + MTX versus MTX in RA. These groups were assessed at baseline and at 4 and 24 weeks, measuring clinical outcomes, total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, and TNF-α. Results. Baseline values for lipid levels were similar in both groups. HDL-C levels increased significantly only in the ETA + MTX group (from 45.5 to 50.0 mg/dL at 4 weeks, a 10.2% increase, , and to 56.0 mg/dL at 24 weeks, a 25.1% increase, ), while other lipids underwent no significant changes. ETA + MTX also exhibited a significant increase in TNF-α (44.8 pg/mL at baseline versus 281.4 pg/mL at 24 weeks, ). The MTX group had no significant changes in lipids or TNF-α. Significant differences in HDL-C between groups were observed at 24 weeks and also in TNF-α  . Conclusion. HDL-C levels increased significantly following treatment with ETA + MTX, without a relationship with decrease of TNF-α.