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Tumour necrosis factor alpha blockade is associated with sustained regression of carotid intima-media thickness for patients with active psoriatic arthritis: a 2-year pilot study
  1. Lai-Shan Tam1,
  2. Edmund K Li1,
  3. Qing Shang1,
  4. Brian Tomlinson1,
  5. Martin Li1,
  6. Ying-Ying Leung2,
  7. Woon Pang Kuan3,
  8. Lai-Wa Kwok1,
  9. Tena K Li1,
  10. Yaner Zhu1,
  11. Emily W Kun4,
  12. Gabriel Yip1,
  13. Cheuk-Man Yu1
  1. 1Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
  2. 2Department of Medicine, North District Hospital, Hong Kong, China
  3. 3Department of Rheumatology, Hospital Selayang, Kuala Lumpur, Malaysia
  4. 4Department of Medicine and Geriatrics, Tai Po Hospital, Hong Kong, China
  1. Correspondence to Dr Lai-Shan Tam, Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China; tamls_813{at}yahoo.com

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We have reported that psoriatic arthritis (PsA) patients without overt cardiovascular diseases have evidence of premature atherosclerosis as indicated by an increased carotid intima-media thickness (IMT).1 Whether an increase in IMT reflects current (but reversible) inflammation of the vessel wall rather than more permanent structural vessel changes in PsA has never been assessed. We undertook a prospective, observational study to determine whether a 12-week treatment of tumour necrosis factor alpha (TNFα) blockers may reduce IMT in patients with active PsA, and whether the changes in IMT can be sustained in patients who were continued on long-term TNFα blockers.

Twenty consecutive PsA patients with active disease were recruited to receive TNFα blockers. After 12 weeks, nine patients continued (group 1) while 11 patients discontinued TNFα blockers due to financial constraints (group 2). Twenty PsA patients who were naive to TNFα blockers were recruited as controls (group 3). Patients …

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