Tocilizumab Effect on Lipid Profile in Correlation to Cardiovascular Events: A Retrospective Cohort Study

Abstract

Objective. To study the effect of tocilizumab initiation on the lipid profile, in correlation to a composite of any cardiovascular events. Methods. A retrospective cohort study, using data from the King Faisal Specialist Hospital & Research Centre database, from January 2014 to December 2019. Patients with rheumatoid arthritis or juvenile idiopathic arthritis who were ≥18 years old, initiated either on tocilizumab or other biologic treatment (anti-TNFs or Rituximab), were included, with a follow-up interval duration at a minimum of 6–12 months up to 3-5 years. Any patient with established cardiovascular disease or aged <18 were excluded. Results. Only one cardiovascular mortality was reported in the tocilizumab group. Fifty percent of patients reached $\text{high}\text{cholesterol}\text{levels}\ge 5.2\text{mmol}/\text{L}$ and $\text{LDL}\ge 3.37\text{mmol}/\text{L}$ in the tocilizumab group at 36 months in a shorter time period compared to controls (60 months), $P$  0.001. There were no significant differences between groups for statin use (27% vs. 28%) However, there was a significantly higher mean dose of atorvastatin in the tocilizumab group compared to controls (20.6 mg vs. 16.6 mg, $P$  0.03). Conclusion. There was a lack of evidence of increased cardiovascular risk in correlation to hyperlipidemia secondary to tocilizumab treatment.