Background Tocilizumab(TCZ) improves artrerial stiffeness. Sometime TCZ improves artrerial stiffness even at higher level of disease activity. There is no evidence that association of disease activity and arterial stiffness after TCZ treatment has not shown.
Objectives To evaluate TCZ therapy improves arterial stiffness beyond its effects of disease activity.
Methods We used only high disease activity data(simplified disease activity index(SDAI) at baseline from our several clinical trial data that were treated by TCZ therapy(n= 87). All 87 RA patients had no previous history of cardiovascular disease or steroid treatment. Patients were divided into low, moderate and high disease activity at one year of TCZ treatment by SDAI(low disease activity(LDA), moderate disease activity(MDA), and high disease activity(HDA)). Arterial stiffness was assessed by cardio-ankle vascular index(CAVI; CAVI is modified Pulse Wave Velocity), and aortic augmentation index normalized to a fixed heart rate of 75 beats per minute (AIx@75). Improvement of CAVI and AIx@75 were compared between LDA, MDA, and HAD at one year of treatment(Kruskal.Wallis).
Results Charatceristics at baseline were similar among the groups(LDA, MDA, and HDA group at one year). Improvement of CAVI was -0.85±0.16, -0.89±0.22, and, -0.84±0.31, respectively(in LDA, MDA and HDA). Improvement of AIx@75 was -2.38±0.35, --1.85±0.32, and, -2.58±0.58, respectively(in LDA, MDA and HAD). Improvement of CAVI and AIx@75 were not correlated disease activity at one year of TCZ treatment(CAVI: p=0.87, AIx@75: p=0.78).
Conclusions TCZ improves arterial stiffness independently of its effects on disease activity, since even in HDA is halted. This indicates that IL-6 inhibition therapy conveys profound anti- arterial stiffness effects and dissociates the link between disease activity and arterial damage.
References: Kume K, Amano K, Yamada S, Hatta K, Ohta H, Kuwaba N. 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.
Disclosure of Interest: None Declared
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