Gabriel Montpied Teaching Hospital, Rheumatology Department, Place H. Dunant, Clermont-Ferrand, 63000, France.
Rheumatology (Oxford). 2013 Jan;52(1):204-9. doi: 10.1093/rheumatology/kes272. Epub 2012 Oct 13.
The increased cardiovascular risk associated with AS is attributable to multiple factors: disease activity, systemic inflammation, traditional risk factors and NSAIDs. This study aimed to investigate the effects of 24 and 52 weeks of TNF-α inhibitor treatment on arterial stiffness and cardiovascular risk factors.
Arterial stiffness was measured using the augmentation index (AIx) and pulse wave velocity (PWV), while other cardiovascular risk factors [lipid profile, blood pressure (BP) and BMI] were collected for active AS patients.
In total, 49 patients, comprising 30 men, were included in the study, with a mean age of 46.9 (12.1) years. Of these, 20 (40.8%) patients were current smokers, while 10 were treated for hypertension. Patients had long-standing [11.9 (9.2) years] and active AS, with a high initial BASDAI [55.0 (18.2)]. Regarding treatment, 26 patients received etanercept, 17 adalimumab and 6 infliximab. No changes were observed in PWV and AIx after 6 or 12 months following TNF-α blockade [PWV 6.97 (2.03) m/s, 6.92 (1.81) m/s and 7.10 (1.95) m/s at baseline, 6 months and 1 year, respectively, P = 0.64; AIx 19.5 (13.1%), 20.2 (12.8%), 18.3 (13.5%), respectively, P = 0.87]. Lipid profiles and other cardiovascular risk factors were unchanged. However, BASDAI, BASFI and biological inflammation were significantly improved.
Arterial stiffness was not improved after 6 and 12 months of anti-TNF-α therapy. However, treatment decreased biological inflammation and disease activity without causing any changes in lipid profiles and other traditional cardiovascular risk factors.
与 AS 相关的心血管风险增加归因于多种因素：疾病活动、全身炎症、传统危险因素和 NSAIDs。本研究旨在探讨 TNF-α 抑制剂治疗 24 周和 52 周对动脉僵硬和心血管危险因素的影响。
通过脉搏波速度（PWV）和增强指数（AIx）测量动脉僵硬，同时收集活动性 AS 患者的其他心血管危险因素[血脂谱、血压（BP）和 BMI]。
共有 49 名患者，包括 30 名男性，纳入研究，平均年龄为 46.9（12.1）岁。其中，20 名（40.8%）患者为当前吸烟者，10 名患者患有高血压。患者的 AS 病史较长[11.9（9.2）年]且处于活动期，初始 BASDAI 较高[55.0（18.2）]。关于治疗，26 名患者接受依那西普治疗，17 名患者接受阿达木单抗治疗，6 名患者接受英夫利昔单抗治疗。TNF-α 阻断治疗后 6 个月和 12 个月时，PWV 和 AIx 无变化[PWV 6.97（2.03）m/s、6.92（1.81）m/s 和 7.10（1.95）m/s 分别在基线、6 个月和 1 年时，P=0.64；AIx 19.5（13.1%）、20.2（12.8%）、18.3（13.5%），P=0.87]。血脂谱和其他心血管危险因素没有变化。然而，BASDAI、BASFI 和生物炎症显著改善。
抗 TNF-α 治疗 6 个月和 12 个月后，动脉僵硬没有改善。然而，治疗降低了生物炎症和疾病活动度，而不会引起血脂谱和其他传统心血管危险因素的变化。
