Effects of adalimumab treatment on vascular disease associated with early rheumatoid arthritis

G. Kerekes, P. Soltész, G. Szűcs, Szilvia Szamosi, H. Dér, Z. Szabó, László Csáthy, Andrea Váncsa, Peter Szodoray, G. Szegedi, Z. Szekanecz

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background: Increased cardiovascular morbidity has become a leading cause of mortality in rheumatoid arthritis (RA). Tumor necrosis factor-alpha (TNFα) inhibitors may influence fow-mediated vasodilation (FMD) of the brachial artery, common carotid intima-media thickness (ccIMT) and arterial stiffness indicated by pulse-wave velocity (PWV) in RA. Objectives: To assess the effects of adalimumab treatment on FMD, ccIMT and PWV in early RA. Methods: Eight RA patients with a disease duration ≤ 1 year received 40 mg adalimumab subcutaneously every 2 weeks. Ultrasound was used to assess brachial FMD and ccIMT. PWV was determined by arteriograph. These parameters were correlated with C-reacive protein, vonWillebrand factor (vWF), immunoglobulin M (IgM)-rheumatoid factor (RF), anti-CCP levels and 28-joint Disease Activity Score (DAS28). Results: Adalimumab therapy successfully ameliorated arthritis as it decreased CRP levels (P = 0.04) and DAS28 (P 〈 0.0001). Endothelial function (FMD) improved in comparison to baseline (P 〈 0.05). ccIMT decreased after 24 weeks, indicating a mean 11.9% significant improvement (P = 0.002). Adalimumab relieved arterial stiffness (PWV) after 24 weeks. Although plasma vWF levels decreased only non-signifcantly after 12 weeks of treatment, an inverse correlation was found between FMD and vWF (R = -0.643, P = 0.007). FMD also inversely correlated with CRP (R = -0.596, P = 0.015). CRP and vWF also correlated with each other (R = 0.598, P = 0.014). PWV and ccIMT showed a positive correlation (R = 0.735, P = 0.038). Conclusions: Treatment with adalimumab exerted favorable effects on disease activity and endothelial dysfunction. It also ameliorated carotid atherosclerosis and arterial stiffness in patients with early RA. Early adalimumab therapy may have an important role in the prevention and management of vascular comorbidity in RA.

Original languageEnglish
Pages (from-to)147-152
Number of pages6
JournalIsrael Medical Association Journal
Volume13
Issue number3
Publication statusPublished - Mar 2011

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Carotid Intima-Media Thickness
Pulse Wave Analysis
Vascular Diseases
Vasodilation
Rheumatoid Arthritis
Vascular Stiffness
R388
Therapeutics
Carotid Artery Diseases
Brachial Artery
Joint Diseases
Rheumatoid Factor
Secondary Prevention
Protein C
Arthritis
Immunoglobulin M
Blood Vessels
Adalimumab
Comorbidity
Arm

Keywords

  • Adalimumab
  • Arterial stiffness
  • Atherosclerosis
  • Carotid intima-media thickness
  • Endothelial dysfunction
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Effects of adalimumab treatment on vascular disease associated with early rheumatoid arthritis. / Kerekes, G.; Soltész, P.; Szűcs, G.; Szamosi, Szilvia; Dér, H.; Szabó, Z.; Csáthy, László; Váncsa, Andrea; Szodoray, Peter; Szegedi, G.; Szekanecz, Z.

In: Israel Medical Association Journal, Vol. 13, No. 3, 03.2011, p. 147-152.

Research output: Contribution to journalArticle

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abstract = "Background: Increased cardiovascular morbidity has become a leading cause of mortality in rheumatoid arthritis (RA). Tumor necrosis factor-alpha (TNFα) inhibitors may influence fow-mediated vasodilation (FMD) of the brachial artery, common carotid intima-media thickness (ccIMT) and arterial stiffness indicated by pulse-wave velocity (PWV) in RA. Objectives: To assess the effects of adalimumab treatment on FMD, ccIMT and PWV in early RA. Methods: Eight RA patients with a disease duration ≤ 1 year received 40 mg adalimumab subcutaneously every 2 weeks. Ultrasound was used to assess brachial FMD and ccIMT. PWV was determined by arteriograph. These parameters were correlated with C-reacive protein, vonWillebrand factor (vWF), immunoglobulin M (IgM)-rheumatoid factor (RF), anti-CCP levels and 28-joint Disease Activity Score (DAS28). Results: Adalimumab therapy successfully ameliorated arthritis as it decreased CRP levels (P = 0.04) and DAS28 (P 〈 0.0001). Endothelial function (FMD) improved in comparison to baseline (P 〈 0.05). ccIMT decreased after 24 weeks, indicating a mean 11.9{\%} significant improvement (P = 0.002). Adalimumab relieved arterial stiffness (PWV) after 24 weeks. Although plasma vWF levels decreased only non-signifcantly after 12 weeks of treatment, an inverse correlation was found between FMD and vWF (R = -0.643, P = 0.007). FMD also inversely correlated with CRP (R = -0.596, P = 0.015). CRP and vWF also correlated with each other (R = 0.598, P = 0.014). PWV and ccIMT showed a positive correlation (R = 0.735, P = 0.038). Conclusions: Treatment with adalimumab exerted favorable effects on disease activity and endothelial dysfunction. It also ameliorated carotid atherosclerosis and arterial stiffness in patients with early RA. Early adalimumab therapy may have an important role in the prevention and management of vascular comorbidity in RA.",
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AU - Kerekes, G.

AU - Soltész, P.

AU - Szűcs, G.

AU - Szamosi, Szilvia

AU - Dér, H.

AU - Szabó, Z.

AU - Csáthy, László

AU - Váncsa, Andrea

AU - Szodoray, Peter

AU - Szegedi, G.

AU - Szekanecz, Z.

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N2 - Background: Increased cardiovascular morbidity has become a leading cause of mortality in rheumatoid arthritis (RA). Tumor necrosis factor-alpha (TNFα) inhibitors may influence fow-mediated vasodilation (FMD) of the brachial artery, common carotid intima-media thickness (ccIMT) and arterial stiffness indicated by pulse-wave velocity (PWV) in RA. Objectives: To assess the effects of adalimumab treatment on FMD, ccIMT and PWV in early RA. Methods: Eight RA patients with a disease duration ≤ 1 year received 40 mg adalimumab subcutaneously every 2 weeks. Ultrasound was used to assess brachial FMD and ccIMT. PWV was determined by arteriograph. These parameters were correlated with C-reacive protein, vonWillebrand factor (vWF), immunoglobulin M (IgM)-rheumatoid factor (RF), anti-CCP levels and 28-joint Disease Activity Score (DAS28). Results: Adalimumab therapy successfully ameliorated arthritis as it decreased CRP levels (P = 0.04) and DAS28 (P 〈 0.0001). Endothelial function (FMD) improved in comparison to baseline (P 〈 0.05). ccIMT decreased after 24 weeks, indicating a mean 11.9% significant improvement (P = 0.002). Adalimumab relieved arterial stiffness (PWV) after 24 weeks. Although plasma vWF levels decreased only non-signifcantly after 12 weeks of treatment, an inverse correlation was found between FMD and vWF (R = -0.643, P = 0.007). FMD also inversely correlated with CRP (R = -0.596, P = 0.015). CRP and vWF also correlated with each other (R = 0.598, P = 0.014). PWV and ccIMT showed a positive correlation (R = 0.735, P = 0.038). Conclusions: Treatment with adalimumab exerted favorable effects on disease activity and endothelial dysfunction. It also ameliorated carotid atherosclerosis and arterial stiffness in patients with early RA. Early adalimumab therapy may have an important role in the prevention and management of vascular comorbidity in RA.

AB - Background: Increased cardiovascular morbidity has become a leading cause of mortality in rheumatoid arthritis (RA). Tumor necrosis factor-alpha (TNFα) inhibitors may influence fow-mediated vasodilation (FMD) of the brachial artery, common carotid intima-media thickness (ccIMT) and arterial stiffness indicated by pulse-wave velocity (PWV) in RA. Objectives: To assess the effects of adalimumab treatment on FMD, ccIMT and PWV in early RA. Methods: Eight RA patients with a disease duration ≤ 1 year received 40 mg adalimumab subcutaneously every 2 weeks. Ultrasound was used to assess brachial FMD and ccIMT. PWV was determined by arteriograph. These parameters were correlated with C-reacive protein, vonWillebrand factor (vWF), immunoglobulin M (IgM)-rheumatoid factor (RF), anti-CCP levels and 28-joint Disease Activity Score (DAS28). Results: Adalimumab therapy successfully ameliorated arthritis as it decreased CRP levels (P = 0.04) and DAS28 (P 〈 0.0001). Endothelial function (FMD) improved in comparison to baseline (P 〈 0.05). ccIMT decreased after 24 weeks, indicating a mean 11.9% significant improvement (P = 0.002). Adalimumab relieved arterial stiffness (PWV) after 24 weeks. Although plasma vWF levels decreased only non-signifcantly after 12 weeks of treatment, an inverse correlation was found between FMD and vWF (R = -0.643, P = 0.007). FMD also inversely correlated with CRP (R = -0.596, P = 0.015). CRP and vWF also correlated with each other (R = 0.598, P = 0.014). PWV and ccIMT showed a positive correlation (R = 0.735, P = 0.038). Conclusions: Treatment with adalimumab exerted favorable effects on disease activity and endothelial dysfunction. It also ameliorated carotid atherosclerosis and arterial stiffness in patients with early RA. Early adalimumab therapy may have an important role in the prevention and management of vascular comorbidity in RA.

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