Effects of 1-year anti-TNF-α therapy on vascular function in rheumatoid arthritis and ankylosing spondylitis

Edit Végh, György Kerekes, Anita Pusztai, Attila Hamar, Szilvia Szamosi, Andrea Váncsa, Levente Bodoki, Lilla Pogácsás, Fruzsina Balázs, Katalin Hodosi, Andrea Domján, Sándor Szántó, Zoltán Nagy, Zoltán Szekanecz, Gabriella Szűcs

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3 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)427-436
Number of pages10
JournalRheumatology International
Issue number3
Publication statusPublished - Mar 1 2020


  • Ankylosing spondylitis
  • Atherosclerosis
  • Cardiovascular disease
  • Carotid intima-media thickness
  • Flow-mediated vasodilation
  • Pulse-wave velocity
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

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  • Cite this

    Végh, E., Kerekes, G., Pusztai, A., Hamar, A., Szamosi, S., Váncsa, A., Bodoki, L., Pogácsás, L., Balázs, F., Hodosi, K., Domján, A., Szántó, S., Nagy, Z., Szekanecz, Z., & Szűcs, G. (2020). Effects of 1-year anti-TNF-α therapy on vascular function in rheumatoid arthritis and ankylosing spondylitis. Rheumatology International, 40(3), 427-436. https://doi.org/10.1007/s00296-019-04497-0