Document Detail

The effect of tumor necrosis factor-α antagonists on arterial stiffness in rheumatoid arthritis: a literature review.
MedLine Citation:
PMID:  22475245     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: There is evidence that patients with rheumatoid arthritis (RA) have a higher arterial stiffness than their age-matched healthy counterparts and thus have a higher cardiovascular risk. Under National Institute for Clinical Excellence guidelines, tumor necrosis factor-α (TNF-α) antagonists are indicated clinically in patients with severe active rheumatoid disease. TNF-α antagonists have been found to reduce inflammatory markers in RA; however, it is debatable if they have favorable effects on the cardiovascular system. This review evaluates the effect of TNF-α antagonists on arterial stiffness, a predictor of cardiovascular disease, in RA patients.
SEARCH STRATEGY: A search of Ovid MEDLINE and ISI Web of Knowledge databases was conducted to identify studies into the effect of TNF-α antagonists on arterial stiffness in RA patients. Eight studies matching the search criteria were included for analysis.
FINDINGS: Two methods were used to assess arterial stiffness: pulse wave velocity and augmentation index. Despite inconsistencies in augmentation index values, aortic pulse wave velocity in all but one study was significantly reduced following TNF-α antagonist treatment. Most studies had methodological limitations, including inadequate sample size, nonblinding of those involved in the measurements, and inadequate inclusion/exclusion criteria. Variation in results could be due to the use of different TNF-α antagonists, different outcome measures being used, and differences in follow-up.
CONCLUSIONS: The balance of evidence suggests that TNF-α antagonists may have a beneficial effect on arterial stiffness and therefore cardiovascular risk. However, larger more robust longer term studies are warranted to confirm recent findings.
Rajdip Dulai; Mark Perry; Richard Twycross-Lewis; Dylan Morrissey; Fabiola Atzeni; Stephen Greenwald
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Publication Detail:
Type:  Journal Article; Review     Date:  2012-04-03
Journal Detail:
Title:  Seminars in arthritis and rheumatism     Volume:  42     ISSN:  1532-866X     ISO Abbreviation:  Semin. Arthritis Rheum.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-24     Completed Date:  2012-11-29     Revised Date:  2014-01-28    
Medline Journal Info:
Nlm Unique ID:  1306053     Medline TA:  Semin Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
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MeSH Terms
Antibodies, Monoclonal / therapeutic use*
Antibodies, Monoclonal, Humanized / therapeutic use
Antirheumatic Agents / therapeutic use*
Arteriosclerosis / complications,  drug therapy*,  physiopathology
Arthritis, Rheumatoid / complications,  drug therapy*,  physiopathology
Databases, Bibliographic
Endothelium, Vascular / drug effects
Immunoglobulin G / therapeutic use
Pulse Wave Analysis
Receptors, Tumor Necrosis Factor / therapeutic use
Treatment Outcome
Tumor Necrosis Factor-alpha / antagonists & inhibitors*
Vascular Resistance / drug effects
Vascular Stiffness / drug effects*,  physiology
Vasodilation / drug effects
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Antirheumatic Agents; 0/Immunoglobulin G; 0/Receptors, Tumor Necrosis Factor; 0/Tumor Necrosis Factor-alpha; 0/infliximab; 185243-69-0/TNFR-Fc fusion protein; FYS6T7F842/adalimumab
Comment In:
Semin Arthritis Rheum. 2013 Dec;43(3):e1-2   [PMID:  23810615 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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