The effect of certolizumab treatment on insulin resistance, lipid
parameters and cardiovascular risk in patients with ankylosing
spondylitis
Abstract
Aims: To evaluate the effects of certolizumab treatment on insulin
resistance (IR), lipid parameters, and cardiovascular (CV) risk in
patients with ankylosing spondylitis (AS). Methods: This prospective
study included 80 consecutive patients with AS (52 males, 28 females)
and 74 control subjects (48 males, 26 feemales). The AS patients and
control group were compared in respect of basal values. All AS patients
with active disease were treated with certolizumab. Biochemical profiles
were obtained before and after 24 weeks of certolizumab treatment.
Homeostatic model assessment-insulin resistance (HOMA-IR) was used to
measure IR and the quantitative insulin sensitivity control index
(QUICKI) was used to measure insulin sensitivity. The Framingham
equation was used to evaluate CV risk factors. Results: A statistically
significant increase was determined in total cholesterol (TC),
high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG)
values after 24 weeks of certolizumab treatment. No statistically
significant change was determined in the plasma atherogenic index (PAI)
and low-density lipoprotein cholesterol (LDL-C) values. A statistically
significant decrease was determined in HOMA-IR and an increase in
QUICKI. When the Framingham risk scoring was compared with the baseline
values, a statistically significant decrease in risk was found at week
24. Conclusions: Certolizumab therapy was associated with a significant
increase in HDL-C, TC, and TG levels without any significant change in
PAI and LDL-C, and was determined to increase insulin sensitivity and
lower insulin resistance. There was also a significant reduction in SBP
and 10-year Framingham risk scores at 24 weeks after the start of
certolizumab therapy.