TY - JOUR
T1 - Arterial wall inflammation in rheumatoid arthritis is reduced by anti-inflammatory treatment
AU - Blanken, Annelies B.
AU - Agca, Rabia
AU - van Sijl, Alper M.
AU - Voskuyl, Alexandre E.
AU - Boellaard, Ronald
AU - Smulders, Yvo M.
AU - van der Laken, Conny J.
AU - Nurmohamed, Michael T.
N1 - Funding Information: We gratefully thank Maqsood Yaqub for technical support and Francine Urbanus for excellent assistance in quantification of the 18F-FDG-PET/CT scans, Jos Twisk for statistical advice and all the patients of the outpatient clinics of Reade and Amsterdam UMC, location VUmc who participated in this study. This study was partly financially supported by AbbVie. There was no involvement in study design, collection, analysis and interpretation of data, writing of the report nor in the decision to submit the article for publication. Publisher Copyright: © 2021 The Authors Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/4/1
Y1 - 2021/4/1
N2 - Background: Rheumatoid arthritis (RA) patients have an increased risk of cardiovascular disease (CVD), partly due to an increased prevalence of cardiovascular risk factors, but also due to chronic systemic inflammation inducing atherosclerotic changes of the arterial wall. The aim of this study was to determine whether anti-inflammatory therapy for the treatment of RA has favorable effects on arterial wall inflammation in RA patients. Methods: Arterial wall inflammation before and after 6 months of anti-inflammatory treatment was assessed in 49 early and established RA patients using 18F-fluorodeoxyglucose-positron emission tomography with computed tomography (18F-FDG-PET/CT). Arterial 18F-FDG uptake was quantified as maximum standardized uptake value (SUVmax) in the thoracic aorta, abdominal aorta, carotid, iliac and femoral arteries. Early RA patients (n = 26) were treated with conventional synthetic disease modifying anti-rheumatic drugs with or without corticosteroids, whereas established RA patients (n = 23) were treated with adalimumab. Results: In RA patients, overall SUVmax was over time reduced by 4% (difference −0.06, 95%CI −0.12 to −0.01, p = 0.02), with largest reductions in carotid (-8%, p = 0.001) and femoral arteries (−7%, p = 0.005). There was no difference in arterial wall inflammation change between early and established RA patients (SUVmax difference 0.003, 95%CI −0.11 to 0.12, p = 0.95). Change in arterial wall inflammation significantly correlated with change in serological inflammatory markers (erythrocyte sedimentation rate and C-reactive protein). Conclusion: Arterial wall inflammation in RA patients is reduced by anti-inflammatory treatment and this reduction correlates with reductions of serological inflammatory markers. These results suggest that anti-inflammatory treatment of RA has favorable effects on the risk of cardiovascular events in RA patients.
AB - Background: Rheumatoid arthritis (RA) patients have an increased risk of cardiovascular disease (CVD), partly due to an increased prevalence of cardiovascular risk factors, but also due to chronic systemic inflammation inducing atherosclerotic changes of the arterial wall. The aim of this study was to determine whether anti-inflammatory therapy for the treatment of RA has favorable effects on arterial wall inflammation in RA patients. Methods: Arterial wall inflammation before and after 6 months of anti-inflammatory treatment was assessed in 49 early and established RA patients using 18F-fluorodeoxyglucose-positron emission tomography with computed tomography (18F-FDG-PET/CT). Arterial 18F-FDG uptake was quantified as maximum standardized uptake value (SUVmax) in the thoracic aorta, abdominal aorta, carotid, iliac and femoral arteries. Early RA patients (n = 26) were treated with conventional synthetic disease modifying anti-rheumatic drugs with or without corticosteroids, whereas established RA patients (n = 23) were treated with adalimumab. Results: In RA patients, overall SUVmax was over time reduced by 4% (difference −0.06, 95%CI −0.12 to −0.01, p = 0.02), with largest reductions in carotid (-8%, p = 0.001) and femoral arteries (−7%, p = 0.005). There was no difference in arterial wall inflammation change between early and established RA patients (SUVmax difference 0.003, 95%CI −0.11 to 0.12, p = 0.95). Change in arterial wall inflammation significantly correlated with change in serological inflammatory markers (erythrocyte sedimentation rate and C-reactive protein). Conclusion: Arterial wall inflammation in RA patients is reduced by anti-inflammatory treatment and this reduction correlates with reductions of serological inflammatory markers. These results suggest that anti-inflammatory treatment of RA has favorable effects on the risk of cardiovascular events in RA patients.
KW - Atherosclerosis
KW - Cardiovascular diseases
KW - Inflammation
KW - Positron emission tomography
KW - Rheumatoid arthritis
UR - http://www.scopus.com/inward/record.url?scp=85103032990&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.semarthrit.2021.03.008
DO - https://doi.org/10.1016/j.semarthrit.2021.03.008
M3 - Article
C2 - 33770536
SN - 0049-0172
VL - 51
SP - 457
EP - 463
JO - Seminars in arthritis and rheumatism
JF - Seminars in arthritis and rheumatism
IS - 2
ER -