RESEARCH - Early treatment reduces the cardiovascular risk factors in newly diagnosed RA patients

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Semin Arthritis Rheum. 2008 Jan 11 [Epub ahead of print]

Early Treatment Reduces the Cardiovascular Risk Factors in Newly

Diagnosed Rheumatoid Arthritis Patients.

Georgiadis AN, Voulgari PV, Argyropoulou MI, Alamanos Y, f M,

Tselepis AD, Drosos AA.

Fellow in Rheumatology, Department of Internal Medicine, Medical

School, University of Ioannina, Ioannina, Greece.

OBJECTIVE: To investigate subclinical atherosclerosis and the effect

of treatment in patients with early rheumatoid arthritis (RA).

PATIENTS AND METHODS: Forty patients with early RA who met the revised

American College of Rheumatology (ACR) criteria and disease duration

of <1 year were included in the study. Smokers and patients with

classical risk factors for atherosclerosis were excluded. The serum

levels of total cholesterol (TC), triglycerides, high-density

lipoprotein cholesterol (HDL-C), and low-density lipoprotein

cholesterol were determined in all patients before and after 1 year of

therapy. Carotid artery intima-media thickness (IMT) and carotid

plaque were measured before and after treatment. RA disease activity

was measured using the 28 joint indices score (DAS-28) and clinical

improvement was determined by the ACR response criteria. Forty-five

age- and sex-matched nonsmoking volunteers were used as controls. All

patients were treated with methotrexate and prednisone. RESULTS: RA

patients had a baseline mild dyslipidemia characterized by a decrease

in serum HDL-C levels and a high TC/HDL-C atherogenic ratio compared

with controls. Both lipid parameters were significantly improved after

treatment (P < 0.01). Common carotid artery IMTs at baseline were

higher in RA patients compared with controls (P < 0.05). After 1 year

of therapy there was a significant decrease in the IMTs (P < 0.001).

Thirty-five patients (88%) achieved the ACR 20%, while 30 (75%)

reached the ACR 50% response criteria. A significant decrease of

DAS-28 was observed after treatment (P < 0.03).

CONCLUSIONS: The atherogenic lipid profile and subclinical

atherosclerosis are features of early RA, which improved after

therapy. Early intervention and control of the disease activity may

reduce the risk of atherosclerosis and cardiovascular events in

patients with RA.

PMID: 18191989

http://www.ncbi.nlm.nih.gov/pubmed/18191989

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