Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Tocilizumab Monotherapy Improves Arterial Stiffness Compared with Other Biologics Monotherapy in Rheumatoid Arthritis.

Kume1,  Kensuke, Amano1,  Kanzo, Yamada1,  Susumu, Ohta2,  Hiroyuki

Hiroshima Clinic, Hiroshima, Japan
IGL School, Hiroshima, Japan

Background:

Methotrexate (MTX) plus TNF inhibitor is very effective in rheumatoid arthritis (RA). But sometimes we choice biologics monotherapy, when it is difficult to use MTX. By the way, patients with RA have an increased cardiovascular (CV) risk. We should have strategies for prevent CV primary in RA patients. And some biologics reduce arterial stiffness and may improve CV morbidity in RA patients.

Objective:

to examine the effect of tocilizumab (TCZ) alone, etanercept (ETN) alone, and Adalimumab (ADA) alone, compared respectively on arterial stiffness in RA patients in an open label randomized study design.

Methods:

RA patients were eligible if they had active disease and no prior treatment with MTX or a TNF inhibitor. All patients have no previous history of CV. 32 RA patients with moderate to severe active disease( DAS 28>3.2) were randomly assigned to receive TCZ alone (n=11), ETN alone (n=11), or ADA alone (n=10). Arterial stiffness was assessed with augmentation index corrected for a heart rate of 75 beats per minute (AIx@75) and cardio-ankle vascular index (CAVI) at baseline, 3 months, and 6 months follow-up. Clinical data was collected at regular visits. CAVI measures arterial stiffness independent of blood pressure and it is superior to brachial ankle pulse wave velocity as an index of arterial stiffness.

Results:

Each groups of characteristics (DAS 28, CRP, diastolic blood pressure, age, gender, disease duration, class) at baseline are no significantly different. Treatment with TCZ (36.3 ± 11, 33.8 ± 3and 33.9± 3%; P = 0.032), ETN (36.4 ± 8, 33.8 ± 5 and 33.5 ± 6%; P = 0.038), ADA (37.1 ± 8, 33.0 ± 5 and 34.1 ± 7%; P = 0.047) attenuated the Aix@75 significantly from baseline to 3 months and 6 months follow-up. Treatment with TCZ (10.82 ± 1.58, 9.62 ± 0.94 and 9.55 ± 1.42%; P = 0.028), ETN (10.92 ± 1.38, 10.29 ± 0.53 and 10.28 ± 1.31%; P = 0.035), ADA (10.74 ± 1.78, 10.38 ± 0.75 and 10.35 ± 0.98%; P = 0.025) attenuated the CAVI significantly from baseline to 3 months and 6 months follow-up. And the CAVI of the TCZ group has most significantly decreased in comparison with the CAVI of ETN or IFX group in 3 and 6 months follow-up.

Conclusions:

Monotherapy of TCZ, ETN, and ADA reduces arterial stiffness in RA patients. TCZ monotherapy improves arterial stiffness more significantly compared with other biologics monotherapy in RA patients.

To cite this abstract, please use the following information:
Kume, Kensuke, Amano, Kanzo, Yamada, Susumu, Ohta, Hiroyuki; Tocilizumab Monotherapy Improves Arterial Stiffness Compared with Other Biologics Monotherapy in Rheumatoid Arthritis. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1839
DOI: 10.1002/art.29604

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