The impact of the lipid profile on the progression and severity of rheumatoid arthritis

Abstract

Background. Rheumatoid arthritis is a systemic autoimmune disease associated with persistent inflammation, symmetric joint involvement, and a progressive, deforming, and destructive course. Dyslipidemias significantly contribute to disease progression and the emergence of extra-articular complications. Objective(s). The aim of this review was to analyze current data on the impact of the lipid profile on rheumatoid arthritis progression and to highlight its prognostic and therapeutic potential. Materials and methods. A systematic review of scientific publications indexed in PubMed and Web of Science covering the period from 2000 to 2024 was carried out. The included sources were meta-analyses, observational studies, and narrative reviews assessing the link between dyslipidemia and the clinical severity of rheumatoid arthritis patients. Results. Most studies have highlighted an atherogenic lipid profile in patients with active rheumatoid arthritis, characterized by decreased HDL levels and increased LDL and triglycerides. Dyslipidemias were correlated with higher clinical scores (DAS28), major cardiovascular risk, and accelerated radiological progression. Biological therapy was found to have significant beneficial effects, contributing to the favorable remodeling of the lipid profile and inflammation reduction. Some studies showed improvements under conventional treatment. Careful monitoring of the lipid profile is essential for management of patients with rheumatoid arthritis. Conclusion(s). Dyslipidemias represent a potential marker of both disease severity and progression in rheumatoid arthritis. Careful monitoring and appropriate adjustment of therapy may have a dual beneficial effect: reducing cardiovascular risk and improving control of the rheumatic disease.