Abstract: This article aims to study lipid profile disorders and the efficacy of phenofibrate (Lipidex SR) in young rheumatoid arthritis (RA) patients with methotrexate (MT) treatment. Materials and methods: We examined 102 patients of RA. Diagnosis of RA has been verified on the basis of classification criteria proposed by the American College of Rheumatologists (ACR) in 1987 and/or criteria of ACR/European Anti-Rheumatic League (EULAR) in 2010. Among the examined, 10 (9.8%) were male, 92 (90.2%) were female and more than half (54%) were young patients under 30. The control group consisted of 110 healthy middle-aged individuals. In the surveyed population, those with 1 to 5 years of age were the largest group (38.3%), followed by those with 5 to 10 years of age (34%). In 66.3% of the patients of RA MT was used as a base preparation. The average dose (median) of MT over the study period was 10 mg per week. 80% of patients took prednisolone in an average dose of 10 mg/day. The content of lipids in venous blood was determined by photocolometry on Vitros SYSTEM Chemistry DT 60 biochemical analyzer (Austria). Results: RA patients who took MT showed a significant increase in the level of triglycerides (TG). Also, it is characterised by an increase in TG levels and a decrease in the concentration of high-density lipoprotein cholesterol (HDL) and an increase in the atherogenicity factor. A more pronounced decrease in HDL levels. Significantly high indicators of the atherogenicity coefficient, which to a lesser extent depended on the duration of MT use. Low-density lipoprotein cholesterol (LDL) and triglyceridemia are also proved to be serious risk factors for atherosclerosis and cardiovascular heart diseases (CHD). Also according to the results of the research, special attention is paid to the use of hypolipidemic drugs, which is promising in improving the prognosis and reducing cardiovascular injuries in RA patients. In the group of patients who received additional lipidex SR, there was a decrease in the level of OHS by 17.1%, an important shift was observed on the part of TG, this indicator decreased by 29.7% and practically did not differ from the control indicators. HDL cholesterol in the SR lipidex group increased significantly by 37.7%. These fibrates have a stimulating effect on all components of atherogenic dyslipidemia and can mitigate the risk of cardiovascular disasters in RA. Conclusion. Thus, in RA patients of young age when using MT there is a reliable increase in the level of Tg, Cholesterol VLDL, a decrease in Cholesterol HDL with an increase in the atherogenicity coefficient, which indicates the proatherogenic effect of the MT base drug against the background of a pronounced fatty hepatosis of the liver. Fibrates have a favorable effect on all components of atherogenic dyslipidemia and can reduce the risk of cardiovascular disasters in RA.