Metabolic syndrome in patients with autoimmune inflammatory rheumatisms

Background: Systemic inflammation has been associated with obesity, with elevated levels of triglycerides and reduced levels of HDL-cholesterol. Aim: To determine the frequency of metabolic syndrome (MetS) in patients suffering of rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) and to compare the evolution of MetS parameters during DMARD (Disease-Modifying Anti-rheumatic Drugs) therapy versus combination of DMARDs and biologics. Methods: The study was conducted on 277 RA patients, 115 AS patients and 103 PsA patients. Patients with inflammatory rheumatisms and MetS were randomized into two groups per disease (RA, AS and PsA). Group 1 underwent DMARD therapy. Group 2 followed a combination of DMARDs and biologics. Patients were assessed for the inflammatory status (C-reactive protein) and MetS (triglycerides, HDL cholesterol and blood pressure) initially, after 1 y and after 2 y. Results: 88 RA patients (31.7%), 16 AS patients (14%) and 35 PsA patients (34%) met the criteria for MetS. RA, AS and PsA patients with MetS who followed a combination of DMARDs and biologic therapy had significant improvement of triglycerides and HDL-cholesterol compared to patients who followed only DMARDs both at 1-y and 2-y assessments. There were no differences of the blood pressure in the two groups. Conclusion: The frequency of MetS was higher in RA and AS patients than in PsA patients. Biologic therapy could influence the evolution of MetS in patients suffering of autoimmune inflammatory rheumatisms