Skip to main content

Advertisement

Log in

Long-term anti-tumour necrosis factor therapy reverses the progression of carotid intima–media thickness in female patients with active rheumatoid arthritis

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

The objective of the study is to evaluate the effect of TNF inhibition on carotid thickness over a 2-year period. 144 women with RA diagnosed according to ACR criteria, without clinical evidence of cardiac and/or vascular disease were enrolled and compared with 78 matched controls. All patients received methotrexate (15–20 mg weekly) for 3 months. Responders (n = 79) continued to be treated with methotrexate, non-responders (n = 40) moved to methotrexate plus a TNF alpha antagonist. Echosonographic studies of carotids were obtained before and after 2-year follow-up. A significant decrease of ca-IMT was observed in anti-TNF-treated patients (P < 0.001); on the other hand, no significant variation of ca-IMT was observed after 2 years in MTX-treated patients. Our study indicates that anti-TNF blocking agents, but not methotrexate, are capable of reducing IMT of carotid arteries in female RA patients in a 2-year follow-up.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Gonzalez-Juanatey C, Llorca J, Testa A, Revuelta J, Garcia-Porrua C, Gonzalez-Gay MA (2003) Increased prevalence of severe subclinical atherosclerotic findings in long-term treated rheumatoid arthritis patients without clinical evident atherosclerotic disease. Medicine (Baltimore) 82:407–413. doi:10.1097/01.md.0000101572.76273.60

    Article  Google Scholar 

  2. Solomon DH, Karlson EW, Rimm EB, Cannuscio CC, Mandl LA, Manson JE et al (2003) Cardiovascular morbidity and mortality in women diagnosed with rheumatoid arthritis. Circulation 107:1303–1307. doi:10.1161/01.CIR.0000054612.26458.B2

    Article  PubMed  Google Scholar 

  3. Fischer LM, Schlienger RG, Matter C, Jick H, Meier CR (2004) Effect of rheumatoid arthritis or systemic lupus erythematosus on the risk of first-time acute myocardial infarction. Am J Cardiol 93:198–200. doi:10.1016/j.amjcard.2003.09.037

    Article  PubMed  Google Scholar 

  4. del Rincòn I, Williams K, Stern MP, Freeman GL, Escalante A (2001) High incidence of cardiovascular events in a rheumatoid arthritis cohort not explained by traditional risk factors. Arthritis Rheum 44:2737–2745. doi:10.1002/1529-0131(200112)44:12<2737::AID-ART460>3.0.CO;2-#

    Article  PubMed  Google Scholar 

  5. Van Doornum S, McColl G, Wicks IP (2002) Accelerated atherosclerosis: an extraarticular feature of rheumatoid arthritis? Arthritis Rheum 46:862–873. doi:10.1002/art.10089

    Article  PubMed  Google Scholar 

  6. Hansel S, Lassig G, Pistrach F, Passauer J (2003) Endothelial dysfunction in young patients with long-term rheumatoid arthritis and low disease activity. Artherosclerosis 170:177–180. doi:10.1016/S0021-9150(03)00281-8

    Article  CAS  Google Scholar 

  7. Vaudo G, Marchesi S, Gerli R, Allegrucci R, Giordano A, Siepi D et al (2004) Endothelial dysfunction in young patients with long-term rheumatoid arthritis and low disease activity. Ann Rheum Dis 63:31–35. doi:10.1136/ard.2003.007740

    Article  CAS  PubMed  Google Scholar 

  8. Sattar N, Mc Carey DW, Capell H, McInnes IB (2003) Explaining how high grade systemic inflammation accelerates vascular risk in rheumatoid arthritis. Circulation 108:2957–2963. doi:10.1161/01.CIR.0000099844.31524.05

    Article  PubMed  Google Scholar 

  9. Hurlimann D, Forster A, Noll G, Enseleit F, Chenevard R, Distler O et al (2002) Anti-tumor necrosis factor-alpha treatment improves endothelial function in patients with rheumatoid arthritis. Circulation 106:2184–2187. doi:10.1161/01.CIR.0000037521.71373.44

    Article  PubMed  Google Scholar 

  10. Gonzalez-Juanatey C, Testa A, Garcia-Castelo A, Garcia-Porrua C, Llorca J, Gonzalez-Gay MA (2004) Active but transient improvement of endothelial function in rheumatoid arthritis patients undergoing long-term treatment with anti-tumor necrosis factor-antibody. Arthritis Rheum 51:447–450. doi:10.1002/art.20407

    Article  CAS  PubMed  Google Scholar 

  11. Maki-Petaja KM, Hall FC, Booth AD, Wallace SM, Yasmin, Bearcroft PW et al (2006) Rheumatoid arthritis is associated with increased aortic pulse-wave velocity, which is reduced by anti-tumor necrosis factor-alpha therapy. Circulation 114(11):1185–1192. doi:10.1161/CIRCULATIONAHA.105.601641

  12. Van Doornum S, McColl G, Wicks IP (2005) Tumour necrosis factor antagonists improve disease activity but not arterial stiffness in rheumatoid arthritis. Rheumatology (Oxford) 44:1428–1432. doi:10.1093/rheumatology/kei033

    Article  Google Scholar 

  13. Irace C, Mancuso G, Fiaschi E et al (2004) Effect of anti TNF alpha therapy on arterial diameter and wall shear stress and HDL cholesterol. Atherosclerosis 177:113–118. doi:10.1016/j.atherosclerosis.2004.04.031

    Article  CAS  PubMed  Google Scholar 

  14. van Halm VP, Nurmohamed MT, Twisk JW, Dijkmans BA, Voskuyl AE (2006) Disease-modifying antirheumatic drugs are associated with a reduced risk for cardiovascular disease in patients with rheumatoid arthritis: a case control study. Arthritis Res Ther 8(5):R151. doi:10.1186/ar2045

    Article  PubMed  Google Scholar 

  15. Gonzalez-Juanatey C, Llorca J, Garcia-Porrua C, Martin J, Gonzalez-Gay MA (2006) Effect of anti-tumor necrosis factor a therapy on the progression of subclinical atherosclerosis in severe rheumatoid arthritis. Arthritis Rheum 55:150–153. doi:10.1002/art.21707

    Article  CAS  PubMed  Google Scholar 

  16. Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324. doi:10.1002/art.1780310302

    Article  CAS  PubMed  Google Scholar 

  17. Prevoo ML, van‘t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL (1995) Modified disease activity scores that include twenty-eight-joint counts: development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 38:44–48. doi:10.1002/art.1780380107

    Article  CAS  PubMed  Google Scholar 

  18. Fries JF, Spitz P, Kraines RG, Holman HR (1980) Measurement of patients outcome in arthritis. Arthritis Rheum 23:137–145. doi:10.1002/art.1780230202

    Article  CAS  PubMed  Google Scholar 

  19. Friedwal WT, Levy RI, Friedckson DS (1972) Estimation of the concentration of low density lipoprotein in plasma, without use of preparative ultracentrifuge. Clin Chem 18:499–502

    Google Scholar 

  20. Van Doornum S, McColl G, Jenkins A, Green DJ et al (2003) Screening for atherosclerosis in patients with rheumatoid arthritis: comparison of two in vivo tests of vascular function. Arthritis Rheum 48:72–80. doi:10.1002/art.10735

    Article  PubMed  Google Scholar 

  21. Mäki-Petäjä KM, Hall FC, Booth AD, Wallace SML et al (2006) Rheumatoid arthritis is associated with increased aortic pulse wave velocity, which is reduced by anti-tumor necrosis factor-alpha therapy. Circulation 114:1185–1192. doi:10.1161/CIRCULATIONAHA.105.601641

    Article  PubMed  Google Scholar 

  22. Park YB, Lee SK, Lee WK, Suh CH et al (1999) Lipid profiles in untreated patients with rheumatoid arthritis. J Rheumatol 26:1701–1704

    CAS  PubMed  Google Scholar 

  23. Grunfeld C, Feingold KR (1991) Tumour necrosis factor, cytokines and the hyperlipidemia of infection. Trends Endocrinol Metab 2:213–219. doi:10.1016/1043-2760(91)90027-K

    Article  CAS  PubMed  Google Scholar 

  24. Spanakis E, Sidiropoulos P, Papadakis J, Ganotakis E et al (2006) Modest but sustained increase of serum high density lipoprotein cholesterol levels in patients with inflammatory arthritides treated with infliximab. J Rheumatol 33:2440–2446

    CAS  PubMed  Google Scholar 

  25. Geroulakos G, O’Gorman DJ, Kalodiki E, Sheridan DJ, Nicolaides AN (1994) The carotid intima–media thickness as a marker of the presence of severe symptomatic coronary artery disease. Eur Heart J 15:781–785

    CAS  PubMed  Google Scholar 

  26. Tang R, Hennig M, Thomasson B, Scherz R et al (2000) Baseline reproducibility of B-mode ultrasonic measurement of carotid artery intima–media thickness: the European Lacidipine Study on Atherosclerosis (ELSA). J Hypertens 18:197–201. doi:10.1097/00004872-200018020-00010

    Article  CAS  PubMed  Google Scholar 

  27. Salonen JT, Salonen R (1993) Ultrasound B-mode imaging in observational studies of atherosclerotic progression. Circulation 87:II56–II65

    CAS  PubMed  Google Scholar 

  28. Bots ML, Evans MA, Riley WA, Grobbee DE (2003) Carotid intima–media thickness measurements in intervention studies. Stroke 34:2985–2994. doi:10.1161/01.STR.0000102044.27905.B5

    Article  PubMed  Google Scholar 

  29. Grobbee DE, Bots ML (1994) Carotid artery intima–media thickness as an indicator of generalized atherosclerosis. J Intern Med 236:567–573

    Article  CAS  PubMed  Google Scholar 

  30. Del Rincon I, O’leary DH, Freeman GL, Escalante A (2007) Acceleration of atherosclerosis during the course of rheumatoid arthritis. Atherosclerosis 195:354–360. doi:10.1016/j.atherosclerosis.2006.09.027

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported in part by a grant from Ministero della Ricerca e della Università of Italy (MIUR).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Giovanni Triolo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ferrante, A., Giardina, A.R., Ciccia, F. et al. Long-term anti-tumour necrosis factor therapy reverses the progression of carotid intima–media thickness in female patients with active rheumatoid arthritis. Rheumatol Int 30, 193–198 (2009). https://doi.org/10.1007/s00296-009-0935-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-009-0935-2

Keywords

Navigation