EFFECT OF RITUXIMAB ON CARDIAC ELECTROPHYSIOLOGICAL PARAMETERS IN PATIENTS WITH RHEUMATOID ARTHRITIS

Abstract

Rheumatoid arthritis (RA) is an autoimmune rheumatic disease characterized by damage not only to the joints, but also to the viscera, including the heart. The cardiovascular risk in patients with RA is 1.5 times higher than that in the general population. In this connection, the treatment should be aimed not only at joint diseases, but should also prevent fatal heart failure. Rituximab (RTM) is a biological drug that has proven to be highly effective in treating different diseases, including RA.Objective: to investigate the effect of RTM on cardiac electrophysiological parameters in patients with RA.Subjects and methods. Examinations were made in 83 patients with seropositive RA, of whom 21 patients received RTM at a dose of 1000 mg according to the scheme for 6–12 months and oral methotrexate at a dose of up to 25 mg weekly (Group 1) and 62 took oral methotrexate at a dose of up to 25 mg weekly for at least 12 months (Group 2). In addition to standard diagnostic methods, the investigators performed electrocardiography to calculate Q–T dispersion and vectorcardiography to determine the loop areas of P, QRS and T, as well as MV vector, MV azimuth, MV elevation.Results and discussion. In Group 1, Q–T dispersion was lower than that in Group 2 (p<0.05). There was also a correlation between ESR and T loop area (r=0.633; p<0.05).Conclusion. When RTM is used, ventricular myocardial repolarization disorders that are a marker of cardiac electrophysiological remodeling and are related to the activity of the disease are less pronounced.

Keywords

• rituximab
• rheumatoid arthritis
• q–t dispersion
• vectorcardiography