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GASPARE PARRINELLO

Long-term anti-tumour necrosis factor therapy reverses the progression of carotid intima-media thickness in female patients with active rheumatoid arthritis

  • Authors: Ferrante, A; Giardina, A; Ciccia, F; Parrinello, G; Licata, G; Avellone, G; Giardina, E; Impastato, R; Triolo, G
  • Publication year: 2009
  • Type: Articolo in rivista (Articolo in rivista)
  • Key words: Rheumatoid arthritis, TNF, DMARDs, Atherosclerosis
  • OA Link: http://hdl.handle.net/10447/49496

Abstract

The objective of the study is to evaluate the effect of TNF inhibition on carotid thickness over a 2-year period. 144 women with RA diagnosed according to ACR criteria, without clinical evidence of cardiac and/or vascular disease were enrolled and compared with 78 matched controls. All patients received methotrexate (15–20 mg weekly) for 3 months. Responders (n = 79) continued to be treated with methotrexate, non-responders (n = 40) moved to methotrexate plus a TNF alpha antagonist. Echosonographic studies of carotids were obtained before and after 2-year follow-up. A significant decrease of ca-IMT was observed in anti-TNF-treated patients (P < 0.001); on the other hand, no significant variation of ca-IMT was observed after 2 years in MTX-treated patients. Our study indicates that anti-TNF blocking agents, but not methotrexate, are capable of reducing IMT of carotid arteries in female RA patients in a 2-year follow-up.