Background Epidemic studies have shown that endothelial dysfunction and accelerated atherosclerosis lead to increased cardiovascular morbidity and mortality in patients with rheumatoid arthritis (RA). Cardio ankle vascular index (CAVI) measures arterial stiffness independent of blood pressure and it is superior to brachial ankle pulse wave velocity as an index of arterial stiffness. The aim of our study was to examine inhibitory effects on atherosclerosis of RA patients by biologic agents.
Objectives We studied 36 RA patients with moderate or more disease activity as defined by the European League Against Rheumatism (EULAR) disease activity score (DAS28-ESR) in spite of MTX treatment.
Methods We measured their CAVI before and after treatment with biologic agents (tocilizumab (TCZ) plus methotrexate (MTX)(n=11), etanercept (ETN) plus MTX (n=12), or MTX alone (n=13)) for one year.
Results Each groups of characteristics (DAS 28, CRP, age, gender, disease duration) at baseline are no significantly different. Treatment with TCZ (9.62±1.56 and 9.05±1.42%, P<0.05), ETN (9.72±1.68 and 9.18±1.34%, P<0.05), but not MTX (9.88±1.63 and 9.79±1.87%; P=0.77) attenuated the CAVI significantly from baseline to 1 year follow-up.
Conclusions TCZ and ETN but not MTX therapy may have a beneficial effect on preventing the progression of subclinical atherosclerosis and arterial stiffness. It remains unknown whether this effect is specific to TNF-alpha antagonists or relates to better control of inflammation irrespective of the disease modification strategy by which this is achieved.
Disclosure of Interest None declared