Inflammation predicts accelerated brachial arterial wall changes in patients with recent-onset rheumatoid arthritis
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Key result
Patients with recent-onset rheumatoid arthritis had significantly impaired flow-mediated dilatation compared to matched controls (5% vs 11%, p=0.001), which improved over one year of treatment in correlation with reduced inflammation.
Study Design
Type
Observational (n=51)
Blinding
Single-blind
Multicenter
No
Structured PICO
P
Population
31 patients with recent-onset rheumatoid arthritis (symptom duration <12 months) and 20 matched healthy controls, followed for 1 year to assess arterial wall changes.
C
Comparator
20 control subjects matched for age, sex and established cardiovascular risk factors
O
Outcome
Brachial artery flow-mediated dilatation (FMD), glyceryl trinitrate (GTN)-mediated dilatation (GMD), and carotid intima media thickness (cIMT) at baseline and change over 12 monthssurrogate
Main Result
Absolute Event Rate: 5% vs 11%
p-value: p=0.001
Patients with recent-onset rheumatoid arthritis exhibit impaired brachial artery endothelial function that can improve over one year, suggesting early control of inflammation may reduce atherosclerotic progression.
Limitations
- Small sample size
- Exact blood pressure and lipid levels were not matched between groups (only matched categorically for hypertension and hyperlipidaemia)
- Observational design without a randomized control group for the treatment phase
Authors
Discussion
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Implication
Early RA inflammation control may improve endothelial function; hypothesis-generating for CV risk reduction, needs RCTs before practice change.
Cite This Study
Hannawi et al. (2009) conducted an observational in Recent-onset rheumatoid arthritis (n=51). Recent-onset rheumatoid arthritis vs. Healthy controls matched for age, sex and cardiovascular risk factors was evaluated on Flow-mediated dilatation (FMD) at baseline (p=0.001). Patients with recent-onset rheumatoid arthritis had significantly impaired flow-mediated dilatation compared to matched controls (5% vs 11%, p=0.001), which improved over one year of treatment in correlation with reduced inflammation.
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