Tumour necrosis factor blocking agents and progression of subclinical atherosclerosis in patients with ankylosing spondylitis.
Ann Rheum Dis
; 74(1): 119-23, 2015 Jan.
Article
em En
| MEDLINE
| ID: mdl-24092419
ABSTRACT
BACKGROUND:
Ankylosing spondylitis (AS) is associated with an increased cardiovascular risk that might be due to the chronic underlying inflammatory process. We investigated whether subclinical atherosclerosis of the carotid artery in patients with AS was reduced after anti-inflammatory treatment with tumour necrosis factor (TNF) inhibitors in a prospective observational cohort study.METHODS:
67 out of 81 AS patients who used TNF inhibitors and underwent ultrasonography at baseline returned for follow-up after 4.9â years. Of all patients, 12 (15%) discontinued the use of TNF inhibitors. Assessments of medication use, AS-related factors and cardiovascular risk factors were measured at baseline and repeated at follow-up. B-mode carotid ultrasonography was used to investigate arterial wall parameters, including carotid intima-media thickness (cIMT) and Young's elastic modulus (YEM).RESULTS:
After a median 4.9â years of follow-up, cIMT did not change significantly (paired t test +0.011â mm, p=0.561) in those who continued the use of TNF inhibitors, while cIMT increased substantially (+0.057â mm, p=0.069) in those who did not continue their use of TNF inhibitors. The effect of TNF inhibitors was mainly mediated by a subsequent decrease in AS disease activity. Vascular elasticity (as measured with YEM) did not change significantly in patients who discontinued TNF inhibitors or those who continued TNF inhibitors.CONCLUSIONS:
The use of TNF inhibitors might stabilise or slow down the progression of subclinical atherosclerosis in AS patients, reflecting a decreased cardiovascular risk in these patients.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Espondilite Anquilosante
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Imunoglobulina G
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Artérias Carótidas
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Doenças das Artérias Carótidas
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Fator de Necrose Tumoral alfa
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Receptores do Fator de Necrose Tumoral
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Antirreumáticos
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Doenças Assintomáticas
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Anticorpos Monoclonais Humanizados
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Ann Rheum Dis
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Holanda