Can targeted therapies for psoriatic arthritis change my cholesterol levels?
Targeted therapies for psoriatic arthritis (PsA) work by calming the immune system, but they can also affect your cholesterol levels. A large analysis of studies found that different types of these drugs have different effects on cholesterol. Some may raise your cholesterol, while others may have little to no effect. It's important to monitor your cholesterol if you are on certain treatments.
What the research says
A systematic review and meta-analysis of 36 studies involving over 24,000 patients with psoriasis or PsA looked at how targeted therapies affect lipid profiles 411. The results show that the type of drug matters. Janus kinase inhibitors (JAKi) were linked to significant increases in total cholesterol, triglycerides, HDL ("good") cholesterol, and LDL ("bad") cholesterol after long-term use 411. In contrast, TNF inhibitors (like adalimumab) and IL-17 inhibitors (like secukinumab) did not cause significant changes in cholesterol levels 411. IL-12/23 inhibitors (like ustekinumab) also showed no major effect on lipids 411. Another review noted that TNF inhibitors may actually reduce vascular inflammation and improve cardiovascular outcomes, which could offset any lipid concerns 9. Because PsA itself increases cardiovascular risk, managing cholesterol is especially important 5.
What to ask your doctor
- Should I have my cholesterol checked before starting a targeted therapy for PsA?
- How often should I monitor my cholesterol while on this medication?
- If I am prescribed a JAK inhibitor, what is the plan for managing potential cholesterol increases?
- Are there lifestyle changes or other medications that can help keep my cholesterol in a healthy range during treatment?
- Does my personal or family history of heart disease affect which targeted therapy is safest for me?
This question is drawn from common patient questions about this topic and answered using cited medical research. We do not provide individualized advice.