RESEARCH - Enbrel improves inflammation-associated arterial stiffness in RA

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Rheumatology (Oxford). 2009 Nov;48(11):1418-23. Epub 2009 Sep 4.

Etanercept improves inflammation-associated arterial stiffness in

rheumatoid arthritis.

Galarraga B, Khan F, Kumar P, Pullar T, Belch JJ.

The Institute of Cardiovascular Research, Vascular and Inflammatory

Diseases Research Unit, Ninewells Hospital and Medical School, Dundee

DD1 9SY, UK.

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

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.

PMID: 19734293

http://www.ncbi.nlm.nih.gov/pubmed/19734293

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