Background Life expectancy in rheumatoid arthritis (RA) patients is reduced by 3-10 years mainly due to cardiovascular diseases. In the core study, we found that selected normotensive, non-diabetic, premenopausal RA patients had increased intima media thickness and more plaques, and thereby accelerated atherosclerosis, comparing to controls. In present follow up study we studied the impact of treatment with biologics and disease activity on progression of atherosclerosis in the same RA patients in a time span of 5.5 years.
Methods The study group comprised of 8 female RA patients who were treated with biologics. RA was diagnosed according to the 1987 revised criteria of the American College of Rheumatology. 60 RA patients not treated with biologics were selected as a control group. Ultrasound examination of carotid arteries was performed. Results of intima media thickness (IMT) and plaques were statistically studied and correlated with classical and non-classical risk factors for atherosclerosis as well with cytokines, adhesion molecules, CRP and disease activity score-28 (DAS-28).
Results The IMT in patients treated with biologics was 0.608 mm and 0.639 mm in those untreated (p>0.05).We calculated the difference of progression in IMT (delta IMT) in patients who were treated with biologics and those who were not (p>0.05). We also calculated the difference in plaque number in patients who were treated with biologics and those who were not. We found plaques in 3 patients treated with biologics and in 14 untreated patients (p>0.05).We compared DAS-28 in patients who were treated with biologics and those who were not. The DAS-28 in patients treated with biologics was 3.45±1.73, and the DAS-28 for patients who did not receive biologics was 4.05±1.43 (p>0.05).
Conclusions The IMT in study RA patients with severe diseases treated with biologics had lower values of IMT and fewer atherosclerotic plaques in comparison to RA patients who did not receive biologics. However they did not reach a statistically significant difference. The patient number is small and the time span is also relatively short. More patients and a longer treatment time are required for better results. It should also be noted that patients with a severe disease are expected to have increased IMT in comparison to those with a less severe disease. Patients with severe disease in our study group received TNF-alpha blockers, which obviously delayed IMT progression.
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Disclosure of Interest None Declared
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