Background Rheumatologists need to develop primary prevention strategies for cardiovascular disease (CVD) in rheumatoid arthritis (RA) patients. We reported that tocilizumab (TCZ) improved arterial stiffness as well as etanercept and adalimumab. There is no evidence that TCZ effects on left ventricular (LV) morphology and function.
Objectives To study the effect of TCZ plus methotrexate (MTX) on LV morphology and function in MTX resistant active RA patients, in a cohort study design.
Methods RA patients were eligible if they had active disease despite treatment with MTX. All patients have no steroids, and no previous history of CVD. Consecutive 23 patients with moderate to severe active RA patients (DAS28>3.2) despite MTX were received TCZ plus MTX. LV morphology and function was assessed with cardio-MRI at baseline and 24 weeks follow-up. Cardiovascular risk factors and clinical data were collected at regular visits.
Results 21 patients completed 24 weeks. Left ventricular mass index (LVMI) was attenuated significantly by TCZ (week 0-week24,−18.8±6.9 g/m2; p=0.0002). Cardiac output (CO) was attenuated significantly by TCZ (week 0-week24,-0.98± 1.4l/min). DAS28 and CRP improved significantly by TCZ (week 0-week24; DAS28: -2.35±0.85; CRP: 24.3±7.2 mg/l) (p<0.05). Surprisingly, the change of disease activity (DAS 28 and CRP) is no correlation with the change of LVMI or CO in this study.
Conclusions TCZ improved LVMI and CO in active RA despite. Interleukin (IL) 6 might be an important role of LV hypertrophy. TCZ, anti- Interleukin (IL) 6 receptor antibody, may prevent cardiovascular morbidity and mortality in RA.
References Kume K, et al. Tocilizumab monotherapy reduces arterial stiffness as effectively as etanercept or adalimumab monotherapy in rheumatoid arthritis: an open-label randomized controlled trial. J Rheumatol. 2011 Oct;38(10):2169-71. doi: 10.3899/jrheum.110340. Epub 2011 Aug 1.PMID: 21807781
Disclosure of Interest None Declared
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