Journal of Inflammation Research (Jun 2018)

Factors correlated with the improvement of endothelial dysfunction during Abatacept therapy in patients with rheumatoid arthritis

  • Benucci M,
  • Bandinelli F,
  • Damiani A,
  • Li Gobbi F,
  • Infantino M,
  • Grossi V,
  • Manfredi M

Journal volume & issue
Vol. Volume 11
pp. 247 – 252

Abstract

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Maurizio Benucci,1 Francesca Bandinelli,1 Arianna Damiani,1 Francesca Li Gobbi,1 Maria Infantino,2 Valentina Grossi,2 Mariangela Manfredi2 1Rheumatology Unit, Hospital S. Giovanni di Dio, Azienda USL-Toscana Centro, Florence, Italy; 2Immunology and Allergology Laboratory Unit, Hospital S. Giovanni di Dio, Azienda USL-Toscana Centro, Florence, Italy Background: Rheumatoid arthritis patients are exposed to a high risk of cardiovascular morbidity and mortality even in the early phases of the disease. Methods: We evaluated carotid common carotid intimal media thickness (ccIMT) intimal thickness and brachial flow-mediated dilation (FMD) of 45 rheumatoid arthritis patients without known cardiovascular risk factors or heart disease on a stable dose of prednisone 5.2±1.2 mg/day and Methotrexate 11.5±2.1 mg at baseline (T0) and after 12 months (T1) of treatment with Abatacept 125 mg/week. The comparison between T0 and T1 (t- and Mann–Whitney test), correlation (Spearman r), and predictivity (linear regression) of FMD, ccIMT vs clinical and laboratory parameters (disease activity 28 score, tumor necrosis factor alpha [TNFα], interleukin-6, erythrocyte sedimentation rate, C-reactive protein (CRP), CD3+, CD3+/CD4+, CD3+/CD8+, CD19+(B), CD20+(B), NK CD3-CD56+CD16+, CD14+ HLA DR+, CD4+CD28+, CD4+CD28, rheumatoid factor IgM, IgA, RF IgG, anti-citrullinated peptide antibodies) were also evaluated. Results: During Abatacept treatment, ccIMT and FMD remained stable and disease activity 28 score, CRP, erythrocyte sedimentation rate, and interleukin-6 decreased significantly (p=0.0001, 0.002, 0.0002, 0.0001 respectively). At T0, only ccIMT resulted as correlated with baseline TNFα values (p=0.0245) in an inverse proportion. At T1, ccIMT correlated with CD3/CD8+ lymphocytes number (p=0.0351) and FMD with CRP (p=0.0075). In regression analysis, baseline ccIMT and FMD had a low predictivity for TNFα (p=0.011) and CRP (p=0.049) at T1, respectively. Conclusion: This study shows that the endothelial function remained stable during Abatacept treatment. Keywords: Abatacept, rheumatoid arthritis, cardiovascular disease

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