Active but transient improvement of endothelial function in RA patients undergoing long-term treatment with anti-TNF alpha antibody

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Arthritis Rheum. 2004 Jun 15;51(3):447-50.

Active but transient improvement of endothelial function in rheumatoid

arthritis patients undergoing long-term treatment with anti-tumor

necrosis factor alpha antibody.

-atey C, Testa A, -Castelo A, -Porrua C, Llorca

J, -Gay MA.

Hospital Xeral Calde, Lugo, Spain.

OBJECTIVE: Cardiovascular disease is the major cause of excessive

mortality in rheumatoid arthritis (RA). Atherosclerosis and RA share

similar inflammatory mechanisms that include involvement of tumor

necrosis factor alpha (TNFalpha). Anti-TNFalpha antibody improved

endothelial function in RA patients after a 12-week treatment. The aim

of the present study was to assess whether improvement of endothelial

function is still effective in long-term infliximab-treated RA patients.

METHODS: Seven RA patients (5 women; age range 25-73 years) were

studied. They had been treated with infliximab for at least 1 year and

were currently being treated with this drug every 8 weeks.

Endothelial-dependent and independent vasodilatation were measured by

brachial ultrasonography. RESULTS: Following infliximab infusion, a

rapid increase in the percentage of endothelial-dependent vasodilatation

was found in all patients (mean +/- SD 9.4 +/- 5.5% 2 days postinfusion

compared with 2.8 +/- 2.5% 2 days before infusion). However, values

returned to baseline by 4 weeks after infusion. There were no

differences in the percentage of endothelial-independent vasodilatation

prior to and after infusion. A decrease in the individual disease

activity score for each patient was observed at day 7 postinfusion (P =

0.02).

CONCLUSION: Our study confirms an active but transient effect of

infliximab on endothelial function in RA patients treated periodically

with this drug. It may support long-term use of drugs that block

TNFalpha function to reduce the high incidence of cardiovascular

complications in RA.

PMID: 15188332

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