TUMOR NECROSIS FACTOR-ALPHA ANTAGONISTS IMPROVE AORTIC STIFFNESS IN PATIENTS WITH INFLAMMATORY ARTHROPATHIES: A ONE YEAR CONTROLLED STUDY: PP.10.412

Abstract

Background: Patients with chronic inflammatory arthropathies such as rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis have increased cardiovascular morbidity and mortality. Effective anti-inflammatory treatment seems to be beneficial not only to counteract the progression of the rheumatic disease, but also with regard to the cardiovascular system. Aim: To examine the effect of one year treatment with Tumor Necrosis Factor (TNF)-α antagonists on arterial stiffness and carotid intima media thickness (cIMT) in patients with inflammatory arthropathies. Methods: A total of 55 patients with RA, AS or PsA and clinical indication for anti-TNF-α therapy were included. 36 patients started with anti-TNF-α therapy and were compared with a non-treatment group of 19 patients. Aortic pulse wave velocity (aPWV) and augmentation index (AIx) were measured at baseline and after 3, 6, 9 and 12 months with the Sphygmocor device. Furthermore, cIMT was measured at baseline and at 6 and 12 months with the Art.Lab system, and disease activity was assessed at each visit. Results: Mean ± SD age in the treatment/control group was 47.2 ± 12.2 / 51.2.0 ± 14.1 years (P = 0.53), 42.9 / 50.0 % (P = 0.63) were females and disease duration was 11.9 ± 9.6 / 10.6 ± 10.1) years (P = 0.31). After 12 months, aPWV was reduced in the treatment group, but not in the control group (-0.52 ± 0.80 m/s versus 0.04 ± 0.48 m/s, respectively; P = 0.001). AIx and cIMT did not change in any of the groups. CRP and Disease Activity Score 28 joints (DAS28) were significantly reduced in the treatment group after 12 months (-8.2 ± 19.2 mg/L P < 0.001 and -1.1 ± 0.9 P = 0.004). The greatest reduction in aPWV was observed from baseline to 3 months and the improvement was maintained the entire observation period (figure 1).Conclusion: These findings indicate that anti-TNF-α therapy improves aortic stiffness in patients with inflammatory arthropathies concurrent with reduction in inflammatory markers.