Etanercept improves inflammation-associated arterial stiffness in rheumatoid arthritis

Bernat Galarraga, Faisel Khan, Pradeep Kumar, Tom Pullar, Jill J. F. Belch

    Research output: Contribution to journalArticle

    44 Citations (Scopus)

    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 (Alx@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 (>10mg/1) showed significantly higher mean Alx@75 than those with low CRP (<= 10mg/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 Alx@75. 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 Alx@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.

    Original languageEnglish
    Pages (from-to)1418-1423
    Number of pages6
    JournalRheumatology
    Volume48
    Issue number11
    DOIs
    Publication statusPublished - 2009

    Keywords

    • Atherosclerosis
    • Inflammation
    • Arterial stiffness
    • Rheumatoid arthritis
    • Etanercept
    • C-REACTIVE PROTEIN
    • FACTOR-ALPHA THERAPY
    • PULSE-WAVE VELOCITY
    • ENDOTHELIAL FUNCTION
    • CARDIOVASCULAR-DISEASE
    • SYSTEMIC INFLAMMATION
    • HYPERTENSIVE PATIENTS
    • AUGMENTATION INDEX
    • BLOOD-DONORS
    • RISK-FACTOR

    Cite this

    Galarraga, Bernat ; Khan, Faisel ; Kumar, Pradeep ; Pullar, Tom ; Belch, Jill J. F. / Etanercept improves inflammation-associated arterial stiffness in rheumatoid arthritis. In: Rheumatology. 2009 ; Vol. 48, No. 11. pp. 1418-1423.
    @article{194a4403e16b42e59da09255f6108210,
    title = "Etanercept improves inflammation-associated arterial stiffness in rheumatoid arthritis",
    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 (Alx@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 (>10mg/1) showed significantly higher mean Alx@75 than those with low CRP (<= 10mg/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 Alx@75. 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 Alx@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.",
    keywords = "Atherosclerosis, Inflammation, Arterial stiffness, Rheumatoid arthritis, Etanercept, C-REACTIVE PROTEIN, FACTOR-ALPHA THERAPY, PULSE-WAVE VELOCITY, ENDOTHELIAL FUNCTION, CARDIOVASCULAR-DISEASE, SYSTEMIC INFLAMMATION, HYPERTENSIVE PATIENTS, AUGMENTATION INDEX, BLOOD-DONORS, RISK-FACTOR",
    author = "Bernat Galarraga and Faisel Khan and Pradeep Kumar and Tom Pullar and Belch, {Jill J. F.}",
    year = "2009",
    doi = "10.1093/rheumatology/kep251",
    language = "English",
    volume = "48",
    pages = "1418--1423",
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    publisher = "Oxford University Press",
    number = "11",

    }

    Etanercept improves inflammation-associated arterial stiffness in rheumatoid arthritis. / Galarraga, Bernat; Khan, Faisel; Kumar, Pradeep; Pullar, Tom; Belch, Jill J. F.

    In: Rheumatology, Vol. 48, No. 11, 2009, p. 1418-1423.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Etanercept improves inflammation-associated arterial stiffness in rheumatoid arthritis

    AU - Galarraga, Bernat

    AU - Khan, Faisel

    AU - Kumar, Pradeep

    AU - Pullar, Tom

    AU - Belch, Jill J. F.

    PY - 2009

    Y1 - 2009

    N2 - 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 (Alx@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 (>10mg/1) showed significantly higher mean Alx@75 than those with low CRP (<= 10mg/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 Alx@75. 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 Alx@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.

    AB - 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 (Alx@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 (>10mg/1) showed significantly higher mean Alx@75 than those with low CRP (<= 10mg/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 Alx@75. 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 Alx@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.

    KW - Atherosclerosis

    KW - Inflammation

    KW - Arterial stiffness

    KW - Rheumatoid arthritis

    KW - Etanercept

    KW - C-REACTIVE PROTEIN

    KW - FACTOR-ALPHA THERAPY

    KW - PULSE-WAVE VELOCITY

    KW - ENDOTHELIAL FUNCTION

    KW - CARDIOVASCULAR-DISEASE

    KW - SYSTEMIC INFLAMMATION

    KW - HYPERTENSIVE PATIENTS

    KW - AUGMENTATION INDEX

    KW - BLOOD-DONORS

    KW - RISK-FACTOR

    U2 - 10.1093/rheumatology/kep251

    DO - 10.1093/rheumatology/kep251

    M3 - Article

    C2 - 19734293

    VL - 48

    SP - 1418

    EP - 1423

    JO - Rheumatology

    JF - Rheumatology

    SN - 1462-0324

    IS - 11

    ER -