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Methotrexate and anti-tumor necrosis factor treatment improves endothelial function in patients with inflammatory arthritis
BACKGROUND: Inflammatory arthritis (IA), including rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA), leads to increased cardiovascular disease occurrence probably due to atherosclerosis. One of the first stages in atherogenesis is endothelial dysfunction (ED). The...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5646156/ https://www.ncbi.nlm.nih.gov/pubmed/29041979 http://dx.doi.org/10.1186/s13075-017-1439-1 |
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author | Deyab, Gia Hokstad, Ingrid Whist, Jon Elling Smastuen, Milada Cvancarova Agewall, Stefan Lyberg, Torstein Ronda, Nicoletta Mikkelsen, Knut Hjeltnes, Gunnbjorg Hollan, Ivana |
author_facet | Deyab, Gia Hokstad, Ingrid Whist, Jon Elling Smastuen, Milada Cvancarova Agewall, Stefan Lyberg, Torstein Ronda, Nicoletta Mikkelsen, Knut Hjeltnes, Gunnbjorg Hollan, Ivana |
author_sort | Deyab, Gia |
collection | PubMed |
description | BACKGROUND: Inflammatory arthritis (IA), including rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA), leads to increased cardiovascular disease occurrence probably due to atherosclerosis. One of the first stages in atherogenesis is endothelial dysfunction (ED). Therefore, we aimed to compare endothelial function (EF) in patients with IA, and to examine the effects of methotrexate (MTX) monotherapy and antitumor necrosis factor (anti-TNF) treatment with or without MTX comedication (anti-TNF ± MTX) on EF. METHODS: From the PSARA observational study, all patients with RA (n = 64), PsA (n = 29), and AS (n = 20) were evaluated for EF. In patients with ED at baseline (n = 40), we evaluated changes in the Reactive Hyperemic Index (RHI) after 6 weeks and 6 months of antirheumatic therapy. RESULTS: In IA patients with ED, RHI significantly improved after 6 weeks (p < 0.001) and 6 months (p < 0.001) of treatment, independent of changes in disease activity parameters. After 6 months, RHI had improved more in the MTX group than in the anti-TNF ± MTX group, and the difference remained statistically significant after adjustments for potential confounders. Among patients with active RA, AS, and PsA, those with AS appeared to have the worst endothelial function, although they were the youngest. CONCLUSION: Treatment with MTX and anti-TNF ± MTX was associated with a relatively fast improvement of EF in IA patients with ED, independent of change in disease activity. Therefore, modes of action other than the anti-inflammatory effect may contribute to the EF improvement. After 6 months, the EF improvement was more pronounced in the MTX group than in the anti-TNF ± MTX group. TRIAL REGISTRATION: Clinicaltrials, NCT00902005. Registered on 13 May 2009. |
format | Online Article Text |
id | pubmed-5646156 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-56461562017-10-26 Methotrexate and anti-tumor necrosis factor treatment improves endothelial function in patients with inflammatory arthritis Deyab, Gia Hokstad, Ingrid Whist, Jon Elling Smastuen, Milada Cvancarova Agewall, Stefan Lyberg, Torstein Ronda, Nicoletta Mikkelsen, Knut Hjeltnes, Gunnbjorg Hollan, Ivana Arthritis Res Ther Research Article BACKGROUND: Inflammatory arthritis (IA), including rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA), leads to increased cardiovascular disease occurrence probably due to atherosclerosis. One of the first stages in atherogenesis is endothelial dysfunction (ED). Therefore, we aimed to compare endothelial function (EF) in patients with IA, and to examine the effects of methotrexate (MTX) monotherapy and antitumor necrosis factor (anti-TNF) treatment with or without MTX comedication (anti-TNF ± MTX) on EF. METHODS: From the PSARA observational study, all patients with RA (n = 64), PsA (n = 29), and AS (n = 20) were evaluated for EF. In patients with ED at baseline (n = 40), we evaluated changes in the Reactive Hyperemic Index (RHI) after 6 weeks and 6 months of antirheumatic therapy. RESULTS: In IA patients with ED, RHI significantly improved after 6 weeks (p < 0.001) and 6 months (p < 0.001) of treatment, independent of changes in disease activity parameters. After 6 months, RHI had improved more in the MTX group than in the anti-TNF ± MTX group, and the difference remained statistically significant after adjustments for potential confounders. Among patients with active RA, AS, and PsA, those with AS appeared to have the worst endothelial function, although they were the youngest. CONCLUSION: Treatment with MTX and anti-TNF ± MTX was associated with a relatively fast improvement of EF in IA patients with ED, independent of change in disease activity. Therefore, modes of action other than the anti-inflammatory effect may contribute to the EF improvement. After 6 months, the EF improvement was more pronounced in the MTX group than in the anti-TNF ± MTX group. TRIAL REGISTRATION: Clinicaltrials, NCT00902005. Registered on 13 May 2009. BioMed Central 2017-10-17 2017 /pmc/articles/PMC5646156/ /pubmed/29041979 http://dx.doi.org/10.1186/s13075-017-1439-1 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Deyab, Gia Hokstad, Ingrid Whist, Jon Elling Smastuen, Milada Cvancarova Agewall, Stefan Lyberg, Torstein Ronda, Nicoletta Mikkelsen, Knut Hjeltnes, Gunnbjorg Hollan, Ivana Methotrexate and anti-tumor necrosis factor treatment improves endothelial function in patients with inflammatory arthritis |
title | Methotrexate and anti-tumor necrosis factor treatment improves endothelial function in patients with inflammatory arthritis |
title_full | Methotrexate and anti-tumor necrosis factor treatment improves endothelial function in patients with inflammatory arthritis |
title_fullStr | Methotrexate and anti-tumor necrosis factor treatment improves endothelial function in patients with inflammatory arthritis |
title_full_unstemmed | Methotrexate and anti-tumor necrosis factor treatment improves endothelial function in patients with inflammatory arthritis |
title_short | Methotrexate and anti-tumor necrosis factor treatment improves endothelial function in patients with inflammatory arthritis |
title_sort | methotrexate and anti-tumor necrosis factor treatment improves endothelial function in patients with inflammatory arthritis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5646156/ https://www.ncbi.nlm.nih.gov/pubmed/29041979 http://dx.doi.org/10.1186/s13075-017-1439-1 |
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