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Brief Paper

 

Subclinical atherosclerosis evolution during 5 years of anti-TNF-alpha treatment in psoriatic arthritis patients

1, 2, 3, 4, 5, 6, 7, 8, 9, 10

 

  1. Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy.
  2. Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy. roberta.ramonda@unipd.it
  3. Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy.
  4. Clinica Medica 3, Department of Medicine DIMED, University of Padova, Italy.
  5. Clinica Medica 3, Department of Medicine DIMED, University of Padova, Italy.
  6. Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy.
  7. Medicina Interna I, Ospedale Ca Foncello, Treviso, Italy.
  8. Medicina Interna I, Ospedale Ca Foncello, Treviso, Italy.
  9. Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy.
  10. Clinica Medica 3, Department of Medicine DIMED, University of Padova; and Dipartimento di Medicina, Ospedale di Mirano, Venezia, Italy.

CER13200
2021 Vol.39, N°1
PI 0158, PF 0161
Brief Paper

purchase article

PMID: 32452348 [PubMed]

Received: 11/02/2020
Accepted : 07/04/2020
In Press: 20/05/2020
Published: 05/02/2021

Abstract

OBJECTIVES:
Our aim was to evaluate subclinical atherosclerosis progression during 5 years of anti-tumour necrosis factor (TNF)-α treatment in psoriatic arthritis (PsA) patients.
METHODS:
Thirty-two consecutive PsA patients starting TNF-α inhibitors were enrolled and evaluated at baseline (T0), 2 years (FU1) and 5 years (FU2) of treatment. Arterial structural properties were evaluated by B-mode ultrasound of mean carotid intima-media thickness (mean-IMT) and maximum IMT (M-MAX) in each segment (common, bulb, internal), bilaterally. Endothelial function was assessed by post-occlusion flow-mediated dilation (FMD) of the brachial artery using high-sensitivity ultrasonography. Treatment response was studied through DAS28 (disease activity score) and inflammatory biomarkers (C-reactive protein, TNF-α, osteoprotegerin). Metrologic and metabolic data were collected.
RESULTS:
At T1, a significant decrease of DAS28 (4.2±0.7 vs. 2.3±0.8, p<0.001) and CRP (11.25±9.16 vs. 2.91±1.72, p<0.01) was observed. Efficacy was preserved at FU2 (DAS28 2.4±0.9, CRP 2.73±2.51; p=ns vs. FU1). Systolic blood pressure and BMI remained stable throughout the follow-up, while diastolic blood pressure decreased significantly from FU1 to FU2 (80±10 vs. 74±7 mmHg, p=0.001). From T0 to FU1 there was an increase of IMT-mean and M-MAX (0.7±0.1 vs. 0.9±0.4 and 0.9±0.2 vs. 1.1±0.4, p<0.01). At FU2, IMT-mean and M-max did not change significantly (0.9±0.3 and 1.1±0.3, p=ns vs. FU1). No significant variation in FMD values was observed during the study period.
CONCLUSIONS:
A slight progression of subclinical atherosclerosis in PsA was observed in the first 2 years of anti-TNF-α treatment. This process seemed to decelerate in follow-up extension to 5 years.

DOI: https://doi.org/10.55563/clinexprheumatol/3qiqk3

Rheumatology Article