Dyslipidemia in systemic connective tissue diseases and the use of corticosteroids

Mitchenko O.I., Bortkevych O.P. , Voronkov L.G.

• State Institution «National scientific center «Institute of Cardiology named after academician M.D. Strazhesko» National Academy of Medical Sciences of Ukraine, Kyiv

Summary. The article provides a modern view of the pathogenetic mechanisms of dyslipidemia formation against the background of systemic connective tissue diseases: rheumatoid arthritis, systemic lupus erythematosus, systemic scleroderma, etc. The pathophysiological pathways of hypercholesterolemia formation against the background of iatrogenic Cushing’s syndrome provoked by chronic use of glucocorticosteroids are considered. The acute and chronic reaction of lipid metabolism in response to corticosteroid therapy is compared depending on the dose of drugs and the duration of their use. An algorithm of measures for stepwise hypolipidemic treatment, including lifestyle modification, as well as a three-step protocol of combined lipid-lowering therapy, is proposed. which includes statin therapy, ezetimibe, and PCSK9 inhibitors.