Objectives To study whether rituximab (RTX) modifies lipid profile, systolic (SBP) and diastolic (DBP) blood pressure, body mass index (BMI), blood glucose level, arterial stiffness (AS), carotid intima-media thickness (cIMT) and the frequency of silent myocardial ischemia (SMI) in women with RA without overt cardiovascular disease (CVD).
Methods 55 women with RA were observed, during this study we determined plasma total cholesterol (TC), HDL-C, LDL-C, and triglyceride (TG) levels, AS (SI - stiffness index, RI – reflection index and frequency of patients (pt) with “stiff arteries”) by digital volume pulse contour analysis (Micro Medical, UK), performed high resolution B-mode carotid ultrasound with measurement of cIMT. Episodes of SMI were investigated by 24 h ECG ambulatory recording. Assessments were performed before and 24 weeks after RTX therapy (2 infusions of 500/1000 mg RTX iv. 14 days apart). Index activity (DAS 28), inflammatory markers (CRP, ESR), RF IgM in serum were measured in all pt.
Results We divided pt into 2 groups: 1 - moderate/good effect (EULAR) of RTX therapy after 24 weeks (41 pt, 75%), 2 - without EULAR effect of RTX therapy after 24 weeks (14 pt, 25%), table 1. Effective RTX therapy resulted in 5% increase in TC, 23% increase in HDL-C as well as 14% decrease in atherogenic index (AI). RTX treatment also resulted in a dramatically decrease in stiffness index (57%), reflection index (24%) and frequency of patients with “stiff arteries” (from 52% to 15%). We observed 9% decreases in cIMTmax at weeks 24. The frequency of SMI was significantly lower after 24 week when before RTX therapy in group 1 (table 1). The improvement of cardiovascular parameters was associated with a significant decrease in CRP level, ESR, RF IgM and DAS 28 in group 1 (p<0,05). There were not significant changes of lipid profile, AS, cIMT and the frequency of SMI in group 2. We also didn't find differences in SBP, DBP, BMI and blood glucose level in group 1 and 2 before and 24 weeks after RTX therapy.
Conclusions Two infusions of RTX in case of moderate/good EULAR effect of therapy exerted favorable effects on lipid profile, arterial stiffness, carotid atherosclerosis and silent myocardial ischemia in women with RA without overt CVD.
Disclosure of Interest None declared