TY - JOUR T1 - Infliximab is Associated with Improvement in Arterial Stiffness in Patients with Early Rheumatoid Arthritis — A Randomized Trial JF - The Journal of Rheumatology JO - J Rheumatol SP - 2267 LP - 2275 DO - 10.3899/jrheum.120541 VL - 39 IS - 12 AU - LAI-SHAN TAM AU - QING SHANG AU - EDMUND K. LI AU - SHANG WANG AU - RUI-JIE LI AU - KA-LAI LEE AU - YING-YING LEUNG AU - KING-YEE YING AU - CHEUK-WAN YIM AU - EMILY W. KUN AU - MOON-HO LEUNG AU - MARTIN LI AU - TENA K. LI AU - TRACY Y. ZHU AU - RICKY K. CHUI AU - LORRAINE TSEUNG AU - SHUI-LIAN YU AU - WOON-PANG KUAN AU - CHEUK-MAN YU Y1 - 2012/12/01 UR - http://www.jrheum.org/content/39/12/2267.abstract N2 - Objective. To determine the efficacy of methotrexate (MTX) with infliximab (IFX) compared with MTX alone in the prevention of atherosclerosis and arterial stiffness in patients with early rheumatoid arthritis (RA). Methods. A randomized, open-label study in which early RA patients with active disease were treated with MTX alone (n = 20) and MTX plus IFX (n = 20) for 6 months. Patients were assessed every 3 months. Patients from the MTX-alone group who failed to achieve 28-joint Disease Activity Score remission (DAS28 ≤ 2.6) at 6 months were permitted to escape to open-label IFX. Intima-media thickness (IMT), pulse wave velocity (PWV), and augmentation index (AIx) were measured at baseline, 6 months, and 12 months. Results. At 6 months, there was a significantly greater reduction in PWV in the MTX-alone group (0.18 ± 1.59 m/s) compared with the MTX plus IFX group (−0.78 ± 1.13 m/s; p = 0.044), accompanied by significantly greater reduction in patient’s global assessment, number of swollen joints, C-reactive protein, and DAS28 in the MTX plus IFX group compared to the MTX-alone group. The changes in IMT and AIx were similar between the 2 groups. At 12 months, there was a trend favoring early combination treatment with regard to the reduction in PWV (p = 0.06). Conclusion. MTX plus IFX causes a more significant reduction in PWV than MTX alone in patients with early RA after 6-month treatment, and further improvement may be achieved in patients who continued on longterm tumor necrosis factor-α blockers, suggesting that early, effective suppression of inflammation may prevent progression of atherosclerosis by improving vascular function. ER -