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Cardiovascular events are the main cause of the increased risk of death in patients with rheumatoid arthritis (RA). Death rates associated with cardiovascular diseases in RA are 50% higher in comparison with the general population. In the last decade several new technologies and new strategy in the treatment of RA were introduced but the risk of cardiovascular incidents remained unchanged. Various alterations of the lipid profile, observed in RA patients during the treatment with disease modifying antirheumatic drugs (DMARDs) are the subject of several and often contraversal studies. In this review we present and analyzed the results of current research on the lipid profile in RA patients treated with the synthetic and biologic DMARDs. The role of the lipid profile alterations in the pathogenesis of accelerated atherosclerosis in RA has been discussed.