RESEARCH - Does TNF-alpha blockade play any role in cardiovascular risk among RA patients?

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Clin Rheumatol. 2009 Oct;28(10):1217-20.

Does TNF-alpha blockade play any role in cardiovascular risk among

rheumatoid arthritis (RA) patients?

Cuchacovich R, Espinoza LR.

Section of Rheumatology, Department of Medicine, LSU Health Sciences

Center, New Orleans, LA, USA.

The aims of this study were to determine the association and potential

mechanisms between TNF-antagonists and increased cardiovascular risk

in rheumatoid arthritis (RA) patients. Three groups of RA patients

were studied; ten treated with TNF-antagonists, 13 with methotrexate,

and 14 were naïve to treatment. Mean age: 47.2 (SD 11.3), 52.3 (SD

16.6), and 51.2 (SD 13.3) years; mean disease duration 102 (SD 90.4),

72.9 (SD 67.3), and 71.3 (SD 87.1) months, and treatment duration 24.2

(SD 18.5), 34.7 (SD 32.2), and 0 months for each group. Clinical data:

systolic and diastolic blood pressure and body mass index were

assessed. Disease activity was determined by DAS-28 index. An ELISA

assay for IL-6, sIL-6 R, IFN-gamma, TNF-alpha, sTNFRI, sTNFRII, IGF I,

and adiponectin were performed. Fasting glucose, insulin, lipid

profile, CRP, and ESR were also done. HOMA-IR and QUICKI indexes were

calculated. Statistically significant differences observed between the

TNF group and the other two groups were: TNF-alpha levels (p, 0.0014),

soluble TNF RII (p, 0.0432), IFN-gamma (p, 0.008), and DAS-28 <2.6 (p,

0.033).

Finding of elevated levels of sTNFRII and IFN-gamma in patients with

RA on anti-TNF suggests that this therapy does not completely suppress

the inflammatory process and may promote atherogenesis.

PMID: 19517156

http://www.ncbi.nlm.nih.gov/pubmed/19517156

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