'Off-target' metabolic effects of anti-inflammatory drugs for autoimmune diseases

AIRDs affect millions of people worldwide and include rheumatoid arthritis, lupus erythematosus and Sjgren's syndrome -- all of which have high rates

Therefore, current treatments for aird are mainly aimed at suppressing symptoms (inflammation), but this is "low target", which means that the drugs can also have unintended side effects

Lead author Dr George Robinson (UCL Medicine Centre for Rheumatology Research) said: "While the pathogenesis of rheumatism remains unclear, several recent studies suggest that cellular metabolism may be triggering or worsening the onset or impact of rheumatism.

"So, in this review, we sought to understand the impact of traditional and emerging therapies on lipid metabolism in aird patients

In this study, published in the Journal of Clinical Investigation, researchers conducted a literature review of more than 200 studies to assess and interpret what is known about target/irrelevant (adverse) effects and the effects of current AIRD therapy on the Mechanisms of action in lipid metabolism, immune cell function and cardiovascular disease risk

"Our study found that current AIRD therapy can improve or worsen lipid metabolism, both of which may lead to inflammation and increased risk of cardiovascular disease," explained Dr.

"Many traditional drugs also require cellular metabolism to be converted into beneficial therapeutic products; however, drug metabolism often involves additional formation of toxic by-products, and the rate of drug metabolism may vary among patients

The review noted that better control of inflammation with an optimal combination of immunosuppressive treatments may improve the metabolic/lipid profile of aird

However, it also revealed that many studies have shown that lipid-lowering drugs (such as statins) are not sufficient to reduce cardiovascular risk in some aird patients, possibly because they do not fully restore anti-inflammatory properties

Dr Robinson added: "Undesirable off-target adverse effects of current treatments for aird present an opportunity for optimal combination therapy targeting lipid metabolism, which can reduce patients' immune complications and potential increased risk of cardiovascular disease

"New therapeutic techniques and research also highlight alternative metabolic pathways that can be more specifically targeted to reduce inflammation, but also prevent the undesirable off-target metabolic consequences of traditional anti-inflammatory therapies

Journal Reference :

1. George Robinson, Ines Pineda-Torra, Coziana Ciurtin, Elizabeth C.