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

György Kerekes, Pál Soltész, Gabriella Szucs, Szilvia Szamosi, Henriett Dér, Zoltán Szabó, László Csáthy, Andrea Váncsa, Peter Szodoray, Gyula Szegedi, Zoltán Szekanecz

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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
Issue number3
Publication statusPublished - Mar 1 2011



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

ASJC Scopus subject areas

  • Medicine(all)

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