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- Title
Effects of 1-year anti-TNF-α therapy on vascular function in rheumatoid arthritis and ankylosing spondylitis.
- Authors
Végh, Edit; Kerekes, György; Pusztai, Anita; Hamar, Attila; Szamosi, Szilvia; Váncsa, Andrea; Bodoki, Levente; Pogácsás, Lilla; Balázs, Fruzsina; Hodosi, Katalin; Domján, Andrea; Szántó, Sándor; Nagy, Zoltán; Szekanecz, Zoltán; Szűcs, Gabriella
- Abstract
Accelerated atherosclerosis, increased cardiovascular morbidity and mortality have been associated with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Vascular function, clinical and laboratory markers and the effects of anti-TNF therapy were assessed in arthritides. Fifty-three 53 patients including 36 RA patients treated with either etanercept (ETN) or certolizumab pegol and 17 AS patients treated with ETN were included in a 12-month follow-up study. Ultrasonography was performed to determine flow-mediated vasodilation (FMD), common carotid intima-media thickness (ccIMT) and arterial pulse-wave velocity (PWV) in all patients. All assessments were performed at baseline and 6 and 12 months after treatment initiation. A significant improvement of brachial artery FMD was observed after 6 months (p = 0.004). A tendency of FMD improvement was also observed after 12 months (p = 0.065). ccIMT did not change throughout the year. PWV significantly improved after 12 months (p = 0.034). Higher baseline ccIMT (p = 0.009) and PWV (p = 0.038) were associated with clinical non-response (cNR) versus response (cR) to biologics. Multiple analysis confirmed the association of baseline ccIMT with age (p = 0.003) and cNR (p = 0.009), as well as that of baseline PWV with age at diagnosis (p = 0.022) and current chest pain (p = 0.004). Treatment itself determined the 12-month changes in FMD (p = 0.020) and PWV (p = 0.007). In a mixed cohort of RA and AS patients, TNF inhibition improved or stabilized vascular pathophysiology. Inflammation may be associated with FMD, while, among others, cNR may influence vascular function.
- Subjects
RHEUMATOID arthritis; CAROTID intima-media thickness; BRACHIAL artery; CHEST pain; ANKYLOSING spondylitis; BIOMARKERS; PATHOLOGICAL physiology
- Publication
Rheumatology International, 2020, Vol 40, Issue 3, p427
- ISSN
0172-8172
- Publication type
Article
- DOI
10.1007/s00296-019-04497-0