Rheumatoid arthritis (RA) is associated with high cardiovascular mortality. It is not clear whether the metabolic consequences of chronic inflammation are involved. Biological disease-modifying anti-rheumatic drugs (bDMARDs) are highly efficient in the treatment of inflammation in RA. In this study, we aimed to describe the metabolic effects of anti-TNF-α treatment in RA patients. The clinical status of 16 patients was assessed using disease activity score-28 (DAS28) and C-reactive protein (CRP). Plasma samples were collected before treatment with anti-TNF-α treatment as well as after three and six months of treatment. Markers of lipid and glucose metabolism, as well as renal biomarkers, were assessed using standard biochemistry. ELISA was used for the quantification of insulin, leptin, and adiponectin. Although fasting insulin decreased by 14% at the end of the study, most of the analyzed parameters did not show any statistically or clinically significant dynamics. The exception was total bilirubin and cholesterol, which increased by 53% and 14%, respectively, after six months of treatment with anti-TNF-α treatment. Anti-TNF-α treatment did not induce major metabolic changes despite the strong anti-inflammatory and clinical symptoms of RA. Further studies will show whether longer observations are required for the detection of the metabolic effects of the anti-inflammatory treatment. Additional research is needed to understand the observed effect of bilirubin as an important endogenous antioxidant.

Sjögren’s syndrome is a slowly progressive, inflammatory autoimmune disease primarily affecting exocrine glands. Lymphocytic infiltrates replace functional epithelium and lead to decreased exocrine secretion of salivary and lacrimal glands - xerocrinopathy. Glands of intestinal system and pulmonary tract, skin and vaginal mucosa may also be affected. The most common extraglandular manifestations of primary Sjögren’s syndrome include skin vasculitis, Raynaud’s phenomenon, functional renal abnormalities, neuropathy and arthritis symptoms. This disorder may appear separately as a primary Sjögren’s syndrome or in connection with other inflammatory rheumatic diseases as secondary Sjögren’s syndrome. Treatment of the disease is based on topical ocular and oral therapy, extraglandular manifestations need to be treated with hydroxychloroquine and severe cases even with corticosteroid or immunosuppressive drugs