Yokoe I, Kobayashi H, Kobayashi Y, Giles J T, Yoneyama K, Kitamura N, Takei M
a Division of Hematology and Rheumatology, Department of Medicine , Nihon University School of Medicine , Tokyo , Japan.
b Division of Rheumatology , Itabashi Chuo Medical Center , Tokyo , Japan.
Scand J Rheumatol. 2018 Sep;47(5):364-370. doi: 10.1080/03009742.2017.1418424. Epub 2018 May 28.
To prospectively investigate the effect of tocilizumab (TCZ) on the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), as a predictor of congestive heart failure (CHF) in patients with active rheumatoid arthritis (RA).
Seventy patients with RA (median age 59 years, 86% female) free of cardiovascular disease were treated with TCZ and followed for 24 weeks. The NT-proBNP levels were measured at baseline and week 24. Thirty healthy controls were included for comparison of normal NT-proBNP levels with those of RA patients.
The NT-proBNP level was significantly higher in patients with RA than in controls (median 42.5 pg/mL vs 109.0 pg/mL, p < 0.001). NT-proBNP levels decreased by 63% over the 24 weeks of TCZ treatment. Multiple linear regression analysis indicated that the percentage change in the NT-proBNP level was significantly associated with that of the Simplified Disease Activity Index (β = 0.356, p = 0.014), even after adjusting for the levels of rheumatoid factor, duration of RA, age, and anti-cyclic citrullinated peptide antibody.
TCZ decreased the NT-proBNP level in patients with RA without preceding cardiovascular disease and CHF. TCZ may have a cardioprotective effect in those with active RA.
前瞻性研究托珠单抗（TCZ）对N端前脑钠肽（NT-proBNP）水平的影响，NT-proBNP是活动性类风湿关节炎（RA）患者充血性心力衰竭（CHF）的预测指标。
70例无心血管疾病的RA患者（中位年龄59岁，86%为女性）接受TCZ治疗，并随访24周。在基线和第24周测量NT-proBNP水平。纳入30名健康对照者，以比较正常NT-proBNP水平与RA患者的水平。
RA患者的NT-proBNP水平显著高于对照组（中位值42.5 pg/mL对109.0 pg/mL，p < 0.001）。在TCZ治疗的24周内，NT-proBNP水平下降了63%。多元线性回归分析表明，即使在调整类风湿因子水平、RA病程、年龄和抗环瓜氨酸肽抗体后，NT-proBNP水平的百分比变化仍与简化疾病活动指数的变化显著相关（β = 0.356，p = 0.014）。
TCZ降低了无心血管疾病和CHF病史的RA患者的NT-proBNP水平。TCZ可能对活动性RA患者具有心脏保护作用。
