Methotrexate and anti-tumor necrosis factor treatment improves endothelial function in patients with inflammatory arthritis
Abstract 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 (...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-10-01
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| Series: | Arthritis Research & Therapy |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13075-017-1439-1 |
| _version_ | 1818540698862878720 |
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| author | Gia Deyab Ingrid Hokstad Jon Elling Whist Milada Cvancarova Smastuen Stefan Agewall Torstein Lyberg Nicoletta Ronda Knut Mikkelsen Gunnbjorg Hjeltnes Ivana Hollan |
| author_facet | Gia Deyab Ingrid Hokstad Jon Elling Whist Milada Cvancarova Smastuen Stefan Agewall Torstein Lyberg Nicoletta Ronda Knut Mikkelsen Gunnbjorg Hjeltnes Ivana Hollan |
| author_sort | Gia Deyab |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-11T21:58:48Z |
| format | Article |
| id | doaj.art-f39971966a2e444181b3a8965c3de612 |
| institution | Directory Open Access Journal |
| issn | 1478-6362 |
| language | English |
| last_indexed | 2024-12-11T21:58:48Z |
| publishDate | 2017-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Arthritis Research & Therapy |
| spelling | doaj.art-f39971966a2e444181b3a8965c3de6122022-12-22T00:49:12ZengBMCArthritis Research & Therapy1478-63622017-10-0119111010.1186/s13075-017-1439-1Methotrexate and anti-tumor necrosis factor treatment improves endothelial function in patients with inflammatory arthritisGia Deyab0Ingrid Hokstad1Jon Elling Whist2Milada Cvancarova Smastuen3Stefan Agewall4Torstein Lyberg5Nicoletta Ronda6Knut Mikkelsen7Gunnbjorg Hjeltnes8Ivana Hollan9Department of Medical Biochemistry, Innlandet Hospital TrustLillehammer Hospital for Rheumatic DiseasesDepartment of Medical Biochemistry, Innlandet Hospital TrustInstitution of Health Care, Health Science PhD Program, Oslo and Akershus University CollegeOslo University HospitalDepartment of Medical Biochemistry, Oslo University HospitalDepartment of Food and Drug, University of ParmaLillehammer Hospital for Rheumatic DiseasesDepartment of Medicine, Innlandet Hospital TrustLillehammer Hospital for Rheumatic DiseasesAbstract 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.http://link.springer.com/article/10.1186/s13075-017-1439-1Inflammatory arthritisMethotrexateAnti-tumor necrosis factorRheumatic arthritisSpondyloarthritis |
| spellingShingle | Gia Deyab Ingrid Hokstad Jon Elling Whist Milada Cvancarova Smastuen Stefan Agewall Torstein Lyberg Nicoletta Ronda Knut Mikkelsen Gunnbjorg Hjeltnes Ivana Hollan Methotrexate and anti-tumor necrosis factor treatment improves endothelial function in patients with inflammatory arthritis Arthritis Research & Therapy Inflammatory arthritis Methotrexate Anti-tumor necrosis factor Rheumatic arthritis Spondyloarthritis |
| 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 | Inflammatory arthritis Methotrexate Anti-tumor necrosis factor Rheumatic arthritis Spondyloarthritis |
| url | http://link.springer.com/article/10.1186/s13075-017-1439-1 |
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