RESEARCH - Enbrel improves inflammation-associated arterial stiffness in RA

[Guest guest]

Rheumatology Advance Access originally published online on September 4, 2009

Rheumatology 2009 48(11):1418-1423; doi:10.1093/rheumatology/kep251

Etanercept improves inflammation-associated arterial stiffness in

rheumatoid arthritis

Bernat Galarraga1, Faisel Khan1, Pradeep Kumar1, Tom Pullar1 and Jill

J. F. Belch1

1The Institute of Cardiovascular Research, Vascular and Inflammatory

Diseases Research Unit, Ninewells Hospital and Medical School, Dundee,

UK.

Abstract

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 (10 mg/l) (33 ± 8 vs 30 ± 8%; P =

0.033). On regression analysis, log10 CRP (β = 0.298; P = 0.002),

gender (β = 0.257; P = 0.007), BMI (β = –0.292; P = 0.004), diastolic

blood pressure (β = 0.260; P = 0.009) and age (β = 0.194; P = 0.046)

were independently associated with AIx75 (DOT) 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.

http://rheumatology.oxfordjournals.org/cgi/content/abstract/48/11/1418?etoc

Not an MD