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Factors correlated with the improvement of endothelial dysfunction during Abatacept therapy in patients with rheumatoid arthritis

Authors Benucci M, Bandinelli F, Damiani A, Li Gobbi F, Infantino M, Grossi V, Manfredi M

Received 12 November 2017

Accepted for publication 9 April 2018

Published 7 June 2018 Volume 2018:11 Pages 247—252

DOI https://doi.org/10.2147/JIR.S156822

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Ms Justinn Cochran

Peer reviewer comments 5

Editor who approved publication: Dr Ning Quan


Maurizio Benucci,1 Francesca Bandinelli,1 Arianna Damiani,1 Francesca Li Gobbi,1 Maria Infantino,2 Valentina Grossi,2 Mariangela Manfredi2

1Rheumatology Unit, Hospital S. Giovanni di Dio, Azienda USL-Toscana Centro, Florence, Italy; 2Immunology and Allergology Laboratory Unit, Hospital S. Giovanni di Dio, Azienda USL-Toscana Centro, Florence, Italy

Background: Rheumatoid arthritis patients are exposed to a high risk of cardiovascular morbidity and mortality even in the early phases of the disease.
Methods: We evaluated carotid common carotid intimal media thickness (ccIMT) intimal thickness and brachial flow-mediated dilation (FMD) of 45 rheumatoid arthritis patients without known cardiovascular risk factors or heart disease on a stable dose of prednisone 5.2±1.2 mg/day and Methotrexate 11.5±2.1 mg at baseline (T0) and after 12 months (T1) of treatment with Abatacept 125 mg/week. The comparison between T0 and T1 (t- and Mann–Whitney test), correlation (Spearman r), and predictivity (linear regression) of FMD, ccIMT vs clinical and laboratory parameters (disease activity 28 score, tumor necrosis factor alpha [TNFα], interleukin-6, erythrocyte sedimentation rate, C-reactive protein (CRP), CD3+, CD3+/CD4+, CD3+/CD8+, CD19+(B), CD20+(B), NK CD3-CD56+CD16+, CD14+ HLA DR+, CD4+CD28+, CD4+CD28, rheumatoid factor IgM, IgA, RF IgG, anti-citrullinated peptide antibodies) were also evaluated.
Results: During Abatacept treatment, ccIMT and FMD remained stable and disease activity 28 score, CRP, erythrocyte sedimentation rate, and interleukin-6 decreased significantly (p=0.0001, 0.002, 0.0002, 0.0001 respectively). At T0, only ccIMT resulted as correlated with baseline TNFα values (p=0.0245) in an inverse proportion. At T1, ccIMT correlated with CD3/CD8+ lymphocytes number (p=0.0351) and FMD with CRP (p=0.0075). In regression analysis, baseline ccIMT and FMD had a low predictivity for TNFα (p=0.011) and CRP (p=0.049) at T1, respectively.
Conclusion: This study shows that the endothelial function remained stable during Abatacept treatment.

Keywords: Abatacept, rheumatoid arthritis, cardiovascular disease

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