Background Psoriatic arthritis (PsA) patients (pts) have increased cardiovascular disease (CVD) risk due to combination of traditional risk factors (TRF) and autoimmune inflammation. Anti-TNF therapy is an effective in PsA but it's cardiovascular effects has still limited data.
Objectives To study the effects of anti-TNF therapy Adalimumab (ADA) on disease activity, carotid intima-media thickness (c-IMT), parameters of arterial stiffness (AS), ambulatory blood pressure monitoring (AMBP) and CVD TRFs in PsA pts.
Methods 20 (F.-14) PsA pts, according to the CASPAR criteria, mean age 45.5 [39.5; 49] years (yrs.), PsA duration – 7.7 [1.5; 22] yrs, DAS 4.61 [2.92; 6.29], C-reactive protein (CRP, mg/l) 27.2 [9.7; 33.7] were included. All pts were treated by ADA 40 mg every other week up to 3 months. At baseline and after 3 months of therapy all pts underwent standard clinical examination, DAS, CRP, total cholesterol (TC), triglycerides (TG), low and high density lipoproteins (LDL/HDL), c-IMT, AS and ABPM. ABPM was performed by standard procedure. AS were measured by Pulce Trace Device (PT 2000, Micro Medical, UK); carotid-femoral pulse wave velocity (PWVcf) were performed with a 4 MHz Doppler probe; index of wave reflection (regidity index) (RI, %) were performed by a digital volume photo-plethysmography transducer; c-IMT were measured using a high-resolution B-mode ultrasound machine. Me [Q25;Q75], Wilcoxon's rank sum test were calculated. All p less then 0.05 considered to statistical significance.
Results By 3 months of therapy DAS/C-RP significantly decreased to 1.6 [1.3; 1.9]/1,8 [0,8; 3,1] accordingly, p=0.001. DAS remission (<1.6) was achieved in 94% of pts. By the end of therapy TC and TG significantly increased from 4.9 [4.5; 5.9] to 5.6 [4.9; 6.3] mmol/l and from 0.8 [0.7; 1.4] to 1.1 [0.9; 1.4] mmol/l accordingly, (for all p=0.03). We didn't find significant differences between baseline and after treatment levels of LDL/HDL level: from 3.3 [2.8; 4.1] to 3.6 [3.3; 4.1] mmol/l and from 1.3 [1.2; 1.5] to 1.3 [1.2; 1.6] mmol/l accordingly, (p=0.13-0.6). By the end of treatment AMBPs parameters didn't significant change as well. By the end of therapy c-IMT significant decreased from 0.8 [0.74; 0.85] mm to 0.73 [0.58; 0.77] mm, p=0.01. By 3 months of therapy all AS parameters significant decreased: PWVcf from 9.9 [7.7; 17.7] to 9.2 [7.4; 10.6] m/s, (p<0.05), RI from 69.5 [58.0; 74.0] % to 49.5 [44.0; 64.0] % (p<0.05).
Conclusions Anti-TNF treatment ADA improves arterial wall state by decrease inflammation but not by modification of CVD TRFs. These dates confirmed the idea that inflammation involved in acceleration of atherosclerosis in PsA pts.
Disclosure of Interest None declared