Key result
TNF-α inhibitors fail to reduce arterial stiffness over 12 months in active AS.
Why the study?
The increased cardiovascular risk in ankylosing spondylitis is linked to multiple factors, but the effects of TNF-α inhibitor treatment on arterial stiffness and cardiovascular risk factors were unclear.
Does TNF-alpha inhibitor treatment improve arterial stiffness in patients with active ankylosing spondylitis?
Observational (n=49)
Does TNF-alpha inhibitor treatment improve arterial stiffness in patients with active ankylosing spondylitis?
Absolute Event Rate: 7.1% vs 6.97%
p-value: p=0.64
TNF-alpha inhibitor therapy for up to 12 months in patients with active ankylosing spondylitis does not significantly improve arterial stiffness or traditional cardiovascular risk factors despite reducing inflammation and disease activity.
Arterial stiffness unchanged by TNF-α inhibitors in active AS; leaves open whether inflammation reduction modifies CV risk in spondyloarthritis.
OBJECTIVE: The increased cardiovascular risk associated with AS is attributable to multiple factors: disease activity, systemic inflammation, traditional risk factors and NSAIDs. This study aimed to investigate the effects of 24 and 52 weeks of TNF-α inhibitor treatment on arterial stiffness and cardiovascular risk factors. METHODS: Arterial stiffness was measured using the augmentation index (AIx) and pulse wave velocity (PWV), while other cardiovascular risk factors [lipid profile, blood pressure (BP) and BMI] were collected for active AS patients. RESULTS: In total, 49 patients, comprising 30 men, were included in the study, with a mean age of 46.9 (12.1) years. Of these, 20 (40.8%) patients were current smokers, while 10 were treated for hypertension. Patients had long-standing [11.9 (9.2) years] and active AS, with a high initial BASDAI [55.0 (18.2)]. Regarding treatment, 26 patients received etanercept, 17 adalimumab and 6 infliximab. No changes were observed in PWV and AIx after 6 or 12 months following TNF-α blockade [PWV 6.97 (2.03) m/s, 6.92 (1.81) m/s and 7.10 (1.95) m/s at baseline, 6 months and 1 year, respectively, P = 0.64; AIx 19.5 (13.1%), 20.2 (12.8%), 18.3 (13.5%), respectively, P = 0.87]. Lipid profiles and other cardiovascular risk factors were unchanged. However, BASDAI, BASFI and biological inflammation were significantly improved. CONCLUSION: Arterial stiffness was not improved after 6 and 12 months of anti-TNF-α therapy. However, treatment decreased biological inflammation and disease activity without causing any changes in lipid profiles and other traditional cardiovascular risk factors.
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Mathieu et al. (2012) conducted an observational in Ankylosing spondylitis (n=49). TNF-α inhibitor treatment vs. Baseline was evaluated on Arterial stiffness measured by pulse wave velocity (PWV) (p=0.64). TNF-α inhibitor treatment for up to 12 months did not significantly change pulse wave velocity (6.97 to 7.10 m/s; P=0.64) or augmentation index (19.5% to 18.3%; P=0.87) in patients with active AS.
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