Rheumatology Xagena

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Rheumatoid arthritis: Adalimumab decreases aortic stiffness independently of its effect in disease activity

Rheumatoid arthritis is associated with increased cardiovascular morbidity and mortality attributed to traditional cardiovascular risk factors and/or the chronic systemic inflammation.

Researchers have investigated the effect of a TNF antagonist Adalimumab ( Humira ) on aortic stiffness in rheumatoid arthritis patients.

18 patients with rheumatoid arthritis and active disease despite therapy with disease modifying antirheumatic drugs ( DMARDs ), treated with Adalimumab ( alone or in combination with DMARDs ) for 12 weeks, were studied.
Eighteen patients with rheumatoid arthritis treated with Methotrexate were included as controls.

Disease activity markers as well as aortic stiffness indices ( carotid-femoral pulse wave velocity-PWV, augmentation index-Aix ), were measured at baseline and at the end of treatment.

Patients were categorized as responders ( decrease of Disease Activity Score [ DAS28 ] more than 1.2 ) or non-responders.

There was a statistically significant decrease in PWV ( from 8.18 ± 2.03 to 7.01 ± 1.78 m/s, p = 0.00006 ) and DAS28 ( from 6.65 ± 1.22 to 4.69 ± 1.46, p = 0.00007 ) in patients with rheumatoid arthritis treated with Adalimumab.

The decrease in PWV was observed both in responders ( n = 12 ) and non-responders ( n = 6 ). Multivariate analysis showed that the decrease of PWV was independent of changes in disease activity or other parameters.
There was no significant change in PWV in patients treated with Methotrexate ( from 8.87 ± 1.91 to 8.41 ± 2.17, p = 0.29 ).
No significant change in Aix or traditional cardiovascular risk factors was observed.

The treatment with Adalimumab has significantly reduced aortic stiffness in patients with rheumatoid arthritis regardless of their response to therapy. These findings imply a direct protective effect of Adalimumab in vascular wall in patients with rheumatoid arthritis. ( Xagena )

Vassilopoulos D et al, Clin Rheumatol 2014; Epub ahead of print