Atherosclerosis progression in psoriatic arthritis patients despite the treatment with tumor necrosis factor-alpha blockers: A two-year prospective observational study |
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| Affiliation: | 1. Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani 2, 35128 Padova, Italy;2. Clinica Medica 4, University of Padova, Padova, Italy;3. Medicina I, Ospedale Ca’ Foncello, Treviso, Italy;4. Laboratory Medicine, University of Padova, Padova, Italy;1. Université Paris Diderot, Service de Rhumatologie, Hôpital Bichat, AP–HP, Paris, France;2. AP–HP, Hôpital Bichat-Claude-Bernard, Département d’Épidémiologie Biostatistique et Recherche Clinique, Paris, France;3. Université Paris Diderot, Sorbonne Paris Cité, Paris, France;4. INSERM, CIE801, Paris, France;5. Université Paris Diderot, Service d’Immunologie, Hôpital Bichat, AP–HP, Paris, France;6. Université Paris Diderot, INSERM U699, Paris, France;1. InterUniversity Centre for the Study on Electromagnetic Field and Biosystems (ICEmB), at University of Rome “Sapienza”, Rome, Italy;2. ICEmB at Italian National Agency New Technology, Energy, Sustainable Economic Development (ENEA), Rome, Italy;1. Department of Rheumatology, Lapeyronie Hospital, Montpellier I University, UMR 5535, EA2415, Montpellier, France;2. Mohammed V-Souissi University, Faculty of Medicine, Laboratory of Biostatistics, Clinical Research and Epidemiology, Rabat, Morocco;3. UFR de médecine, université-Pierre-et-Marie-Curie–Paris-VI, 75013 Paris, France;1. Rheumatology and Rehabilitation Department, Faculty of medicine Cairo University, Cairo, Egypt;2. Rheumatology and Rehabilitation Department, Faculty of medicine, Dr. Erfan and Bagedo General Hospital, Jeddah, Saudi Arabia;3. Radiology Department, Faculty of medicine, Cairo University, Cairo, Egypt;4. Radiology Department, Dr. Erfan and Bagedo General Hospital, Jeddah, Saudi Arabia;5. Rheumatology and Rehabilitation Department, Suez Canal University, Ismailia, Egypt;6. Cardiology Department, Al-Azhar university, Faculty of Medicine, Cairo, Egypt;7. Internal medicine department faculty of medicine Cairo University, Cairo, Egypt;8. Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt;9. Rheumatology Department, University of Twente, Enschede, The Netherlands;1. Rheumatology Department, Hospital Universitario de Guadalajara, Guadalajara, Spain;2. Institute for Musculoskeletal Health, Madrid, Spain;3. Rheumatology Department, Hospital Universitario Marqués de Valdecilla, Facultad de Medicina, Universidad de Cantabria, Santander, Spain;4. Rheumatology Department, Hospital Universitario Doctor Negrín, Las Palmas de Gran Canaria, Spain;5. Rheumatology Department, Complejo Hospitalario Universitario de Vigo, Instituto de Investigación Biomédica de Vigo, Vigo, Spain;6. Rheumatology Department, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Spain |
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| Abstract: | ObjectiveTo evaluate the progression of subclinical atherosclerosis in Psoriatic Arthritis (PsA) patients treated with anti-tumor necrosis factor (TNF)-α agents.MethodsThirty-two PsA patients classified according to the CASPAR criteria and attending the Rheumatology Unit of the University of Padua Medical Center were enrolled in a two-year prospective, observational study. In accordance with the ASAS/EULAR recommendations on the management of these patients, those studied were prescribed biological agents [etanercept (n = 21), adalimumab (n = 6), infliximab (n = 5)]. Plasma lipids, inflammatory biomarkers, including C-reactive protein (CRP), interleukin-6 (IL-6), vessel endothelium growth factor (VEGF), osteoprotegerin (OPG), and TNF-α, as well as Disease Activity Score 28 calculated with CRP (DAS 28-CRP) were evaluated at baseline and after two years of treatment. Bilateral carotid B-mode ultrasound measurements [the mean-intima media thickness (mean-IMT), the mean maximum-IMT (M-Max)] of each carotid artery segment (common, bulb, and internal carotid artery) and the post-occlusion flow-mediated dilation (FMD) of the brachial artery were also assessed at baseline and after two years.ResultsDespite an improvement in the DAS 28-CRP score (P < 0.0005) and lower low-density lipoprotein cholesterol (P < 0.013) and triglyceride (P < 0.036) values, there was a significant progression in both the mean-IMT (P < 0.0005) and M-Max (P < 0.0005). Moreover, no recovery in FMD (P = ns) was observed after two years of anti TNF-α treatment. Serum TNF-α levels were increased (P = 0.003) and OPG values were decreased (P = 0.011) at the end of follow- up with respect to baseline values.ConclusionsDespite improvement in clinical status, arterial remodelling was observed in the PsA patients who were treated with anti TNF-α agents for two years. |
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| Keywords: | Psoriatic arthritis Atherosclerosis Tumor necrosis factor-α Carotid ultrasound Flow-mediated dilation Intima media thickness |
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