Document Detail

Etanercept improves inflammation-associated arterial stiffness in rheumatoid arthritis.
MedLine Citation:
PMID:  19734293     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Increased arterial stiffness, an independent risk factor for premature coronary artery disease, has been reported in patients with RA. The objectives of this study were first to assess, in patients with RA, the relationship between disease activity, inflammation and augmentation index, which is a combined measure of arterial stiffness and pulse wave reflection. The second objective was to establish any effect anti-rheumatic treatment may have on augmentation index. METHODS: One hundred and forty-eight RA patients with no previous history of cardiovascular disease (CVD) had their augmentation index corrected for a heart rate of 75 beats per minute (AIx@75), and parameters of RA disease activity and CV risk measured. Forty-seven patients were then treated with either MTX (n = 21) or etanercept (ETAN) (n = 26), and assessments were repeated at 2 and 4 months. RESULTS: Patients with high CRP (> 10 mg/l) showed significantly higher mean AIx@75 than those with low CRP (< or = 10 mg/l) (33 +/- 8 vs 30 +/- 8%; P = 0.033). On regression analysis, log(10) CRP (beta = 0.298; P = 0.002), gender (beta = 0.257; P = 0.007), BMI (beta = -0.292; P = 0.004), diastolic blood pressure (beta = 0.260; P = 0.009) and age (beta = 0.194; P = 0.046) were independently associated with AIx@75. Treatment with ETAN (35 +/- 9, 32.5 +/- 1 and 32.5 +/- 8%; P = 0.025) but not MTX (31 +/- 1, 31 +/- 1 and 31 +/- 1%; P = 0.971) attenuated the AIx@75 significantly from baseline to Visits 2 and 3. CONCLUSIONS: Systemic inflammation (CRP) is an independent predictor of arterial stiffness and pulse wave reflection in patients with RA. ETAN but not MTX therapy reduces arterial stiffness and pulse wave reflection and may thus improve CV morbidity in RA.
Bernat Galarraga; Faisel Khan; Pradeep Kumar; Tom Pullar; Jill J F Belch
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2009-09-04
Journal Detail:
Title:  Rheumatology (Oxford, England)     Volume:  48     ISSN:  1462-0332     ISO Abbreviation:  Rheumatology (Oxford)     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-19     Completed Date:  2009-12-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883501     Medline TA:  Rheumatology (Oxford)     Country:  England    
Other Details:
Languages:  eng     Pagination:  1418-23     Citation Subset:  AIM; IM    
The Institute of Cardiovascular Research, Vascular and Inflammatory Diseases Research Unit, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.
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MeSH Terms
Antirheumatic Agents / pharmacology*,  therapeutic use
Arthritis, Rheumatoid / blood,  drug therapy,  physiopathology*
C-Reactive Protein / metabolism
Elasticity / drug effects
Immunoglobulin G / pharmacology*,  therapeutic use
Inflammation / blood,  drug therapy,  physiopathology*
Inflammation Mediators / metabolism
Middle Aged
Pulsatile Flow / drug effects
Radial Artery / drug effects*,  physiopathology
Receptors, Tumor Necrosis Factor / therapeutic use
Treatment Outcome
Vascular Resistance / drug effects
Reg. No./Substance:
0/Antirheumatic Agents; 0/Immunoglobulin G; 0/Inflammation Mediators; 0/Receptors, Tumor Necrosis Factor; 185243-69-0/TNFR-Fc fusion protein; 9007-41-4/C-Reactive Protein

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