Internal Medicine Unit, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
Autoimmun Rev. 2019 May;18(5):501-509. doi: 10.1016/j.autrev.2019.03.008. Epub 2019 Mar 4.
Rheumatoid arthritis (RA) is burdened by a significant increase in cardiovascular disease (CVD) risk. Amongst CVD risk factors, endothelial dysfunction and arterial stiffness represent powerful predictors of atherosclerosis and cardiovascular events in the general population and in RA patients.
A systematic review of the literature was performed to identify the available data on the effect of non-TNF-targeted biologics licensed for the treatment of RA on endothelial function, arterial stiffness or subclinical atherosclerosis. MedLine (via PubMed), Cochrane Central Register of Controlled Trials (CENTRAL) and Web of Science (WOS) databases were searched using a predefined strategy to identify relevant articles.
The search strategy initially retrieved 389 records. After screening titles and abstracts, a total of 362 studies were excluded. Amongst the remaining 27 studies selected for final examination, 16 articles were included in the systematic literature review. Included studies demonstrated a significant effect of abatacept, anakinra, rituximab and tocilizumab in improving endothelial dysfunction associated with RA; the effect on arterial stiffness was less consistent and deserves further investigation. No significant effect of non-TNF-targeted biologics was observed for measures of subclinical atherosclerosis.
Non-TNF-targeted biologics have been associated with favorable effects on endothelial dysfunction as already demonstrated for TNF inhibitors. Future studies are needed to ascertain the impact of this mediations on arterial stiffness in RA patients.
类风湿关节炎（RA）患者的心血管疾病（CVD）风险显著增加。在 CVD 风险因素中，内皮功能障碍和动脉僵硬是普通人群和 RA 患者发生动脉粥样硬化和心血管事件的强有力预测因子。
系统检索文献，以确定已发表的关于非 TNF 靶向生物制剂治疗 RA 对内皮功能、动脉僵硬或亚临床动脉粥样硬化影响的可用数据。使用预先确定的策略在 MedLine（通过 PubMed）、Cochrane 对照试验中心注册库（CENTRAL）和 Web of Science（WOS）数据库中搜索相关文章。
检索策略最初检索到 389 条记录。经过筛选标题和摘要，共排除 362 项研究。在剩余的 27 项选定进行最终检查的研究中，有 16 篇文章被纳入系统文献综述。纳入的研究表明，阿巴西普、阿那白滞素、利妥昔单抗和托珠单抗可显著改善与 RA 相关的内皮功能障碍；而对动脉僵硬的影响则不太一致，需要进一步研究。非 TNF 靶向生物制剂对亚临床动脉粥样硬化的测量指标没有显著影响。
非 TNF 靶向生物制剂已被证明与 TNF 抑制剂一样，对内皮功能障碍具有有利影响。需要进一步的研究来确定这些药物对 RA 患者动脉僵硬的影响。
