Document Detail

Effects of adalimumab treatment on vascular disease associated with early rheumatoid arthritis.
MedLine Citation:
PMID:  21608334     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Increased cardiovascular morbidity has become a leading cause of mortality in rheumatoid arthritis (RA). Tumor necrosis factor-alpha (TNFa) inhibitors may influence flow-mediated vasodilation (FMD) of the brachial artery, common carotid intima-media thickness (ccIMT) and arterial stiffness indicated by pulse-wave velocity (PWV) in RA.
OBJECTIVES: To assess the effects of adalimumab treatment on FMD, ccIMT and PWV in early RA.
METHODS: Eight RA patients with a disease duration < or =1 year received 40 mg adalimumab subcutaneously every 2 weeks. Ultrasound was used to assess brachial FMD and ccIMT. PWV was determined by arteriograph. These parameters were correlated with C-reactive protein, vonWillebrand factor (vWF), immunoglobulin M (IgM)-rheumatoid factor (RF), anti-CCP levels and 28-joint disease activity score (DAS28).
RESULTS: Adalimumab therapy successfully ameliorated arthritis as it decreased CRP levels (P = 0.04) and DAS28 (P < 0.0001). Endothelial function (FMD) improved in comparison to baseline (P < 0.05). ccIMT decreased after 24 weeks, indicating a mean 11.9% significant improvement (P = 0.002). Adalimumab relieved arterial stiffness (PWV) after 24 weeks. Although plasma vWF levels decreased only non-significantly after 12 weeks of treatment, an inverse correlation was found between FMD and vWF (R = -0.643, P = 0.007). FMD also inversely correlated with CRP (R = -0.596, P= 0.015). CRP and vWF also correlated with each other (R = 0.598, P = 0.014). PWV and ccIMT showed a positive correlation (R = 0.735, P = 0.038).
CONCLUSIONS: Treatment with adalimumab exerted favorable effects on disease activity and endothelial dysfunction. It also ameliorated carotid atherosclerosis and arterial stiffness in patients with early RA. Early adalimumab therapy may have an important role in the prevention and management of vascular comorbidity in RA.
György Kerekes; Pál Soltész; Gabriella Szucs; Szilvia Szamosi; Henriett Dér; Zoltán Szabó; László Csáthy; Andrea Váncsa; Peter Szodoray; Gyula Szegedi; Zoltán Szekanecz
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Israel Medical Association journal : IMAJ     Volume:  13     ISSN:  1565-1088     ISO Abbreviation:  Isr. Med. Assoc. J.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-05-25     Completed Date:  2011-06-14     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  100930740     Medline TA:  Isr Med Assoc J     Country:  Israel    
Other Details:
Languages:  eng     Pagination:  147-52     Citation Subset:  IM    
Cardiovascular Unit, Third Department of Medicine, University of Debrecen Medical and Health Science Center, Debrecen, Hungary.
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MeSH Terms
Antibodies, Monoclonal / therapeutic use*
Antibodies, Monoclonal, Humanized
Antirheumatic Agents / therapeutic use*
Arthritis, Rheumatoid / complications*
Atherosclerosis / physiopathology,  prevention & control*
Brachial Artery / physiopathology,  ultrasonography
Carotid Artery, Common / physiopathology,  ultrasonography
Endothelium, Vascular / drug effects
Middle Aged
Vascular Diseases / etiology,  prevention & control*
Vasodilation / drug effects*
von Willebrand Factor / analysis
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Antirheumatic Agents; 0/von Willebrand Factor; FYS6T7F842/adalimumab

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