Clinical significance of brachial flow-mediated dilation in patients with rheumatoid arthritis

Int J Rheum Dis. 2014 Jan;17(1):26-33. doi: 10.1111/1756-185x.12021. Epub 2013 Jan 18.

Abstract

Aim: This study aimed to clarify whether different anti-tumor necrosis factor (TNF) drugs can improve endothelial function better than conventional disease-modifying anti-rheumatic drugs (DMARDs) in a series of Japanese patients with rheumatoid arthritis (RA).

Method: Twenty-five patients who met the American College of Rheumatology 1987 revised diagnostic criteria for RA were randomly selected for this study. The percentage of brachial flow-mediated dilation (%FMD) and maximum carotid intima-media thickness were examined by ultrasonography.

Results: The %FMD in the group treated with anti-TNF therapy was significantly higher than that in the group treated with DMARDs (P < 0.001). The %FMD was significantly correlated with anti-TNF therapy (r = 0.684, P < 0.001) and Disease Activity Score C-reactive protein (r = -0.404, P < 0.05). Multiple regression analysis revealed that anti-TNF therapy was significantly associated with %FMD (β = 0.684, P < 0.001).

Conclusion: Anti-TNF therapy may influence endothelial function more than conventional DMARD therapy. Prospective longitudinal studies examining whether anti-TNF therapy was able to improve endothelial function are required.

Keywords: atherosclerosis; brachial flow-mediated dilation; carotid intima-media thickness; rheumatoid arthritis; ultrasonography.

MeSH terms

  • Adult
  • Aged
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / diagnostic imaging
  • Arthritis, Rheumatoid / drug therapy
  • Arthritis, Rheumatoid / immunology
  • Arthritis, Rheumatoid / physiopathology*
  • Biological Products / therapeutic use
  • Brachial Artery / diagnostic imaging
  • Brachial Artery / drug effects
  • Brachial Artery / physiopathology*
  • Carotid Artery Diseases / diagnostic imaging
  • Carotid Artery Diseases / physiopathology
  • Carotid Intima-Media Thickness
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Predictive Value of Tests
  • Regional Blood Flow
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Vasodilation* / drug effects

Substances

  • Antirheumatic Agents
  • Biological Products
  • Tumor Necrosis Factor-alpha