Short-Term Improvement Of Endothelial Function In Rituximab-Treated Rheumatoid Arthritis Patients Refractory To Tumor Necrosis Factor α Blocker Therapy

    loading  Checking for direct PDF access through Ovid

Abstract

Objective

Cardiovascular disease is the major cause of excessive mortality in rheumatoid arthritis (RA) and endothelial dysfunction plays a key role in atherosclerosis. The aim of the present study was to assess whether rituximab therapy was able to improve endothelial function in RA patients refractory to tumor necrosis factor α (TNFα) blockers.

Methods

Six consecutive RA patients (5 women; age range 55–79 years) with active disease refractory to TNFα inhibitor therapy were studied. Patients received intravenous rituximab (1 course, consisting of 2 infusions of 1,000 mg each separated by 2 weeks). Flow-mediated endothelium-dependent vasodilatation (FMD%) and endothelium-independent vasodilatation (postnitroglycerin) were measured at day 0 prior to the first rituximab infusion, at week 2 (before the second infusion), and at month 6.

Results

At week 2, a dramatic increase in FMD% values was observed in all patients (mean ± SD 7.02 ± 2.31%, median 7.29%, range 3.2–9.75%) compared with those observed before the first infusion (mean ± SD 3.35 ± 1.58%, median 3.04%, range 1.69–5.89%). In addition, at month 6, FMD% values in all patients (mean ± SD 7.66 ± 1.73%, median 7.64%, range 5.61–9.98%) were greater than those found before the first infusion (P = 0.03). The dramatic improvement of FMD% was associated with a significant decrease in C-reactive protein level and Disease Activity Score in 28 joints.

Conclusion

Our study demonstrates an active effect of rituximab on endothelial function in RA patients refractory to TNFα blockers.

Related Topics

    loading  Loading Related Articles