PROGRESSION OF CAROTID ARTERY ATHEROSCLEROSIS DURING TREATMENT TO TARGET IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS
Rheumatoid arthritis (RA) is a disease with a high cardiovascular risk. The results of works on the impact of antirheumatic therapy on carotid artery (CA) intima-media thickness (IMT) are contradictory. Objective: to assess the time course of changes in CA IMT and CA atherosclerosis (CAA) in patient...
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2018-09-01
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| Series: | Научно-практическая ревматология |
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| author | E. V. Udachkina D. S. Novikova T. V. Popkova I. G. Kirillova E. I. Markelova Yu. N. Gorbunova D. E. Karateev E. L. Luchikhina N. V. Demidova M. A. Borisova G. V. Lukina S. I. Glukhova A. V. Volkov |
| author_facet | E. V. Udachkina D. S. Novikova T. V. Popkova I. G. Kirillova E. I. Markelova Yu. N. Gorbunova D. E. Karateev E. L. Luchikhina N. V. Demidova M. A. Borisova G. V. Lukina S. I. Glukhova A. V. Volkov |
| author_sort | E. V. Udachkina |
| collection | DOAJ |
| description | Rheumatoid arthritis (RA) is a disease with a high cardiovascular risk. The results of works on the impact of antirheumatic therapy on carotid artery (CA) intima-media thickness (IMT) are contradictory. Objective: to assess the time course of changes in CA IMT and CA atherosclerosis (CAA) in patients with early RA during treatment to target at a 18-month follow-up. Subjects and methods. The investigation enrolled patients with early RA (disease duration of less than 12 months), who had not previously taken disease-modifying antirheumatic drugs and glucocorticoids. Duplex scanning (DS) of the CA was performed with IMT measurement at baseline and at 18 months after treatment. Vascular atherosclerotic lesion was recorded when atherosclerotic plaque (ASP) was detected. Starting methotrexate (MTX) monotherapy was prescribed to all the patients, when it showed an insufficient effect at 3 months, a biological agent (BA), such as a tumor necrosis factor-α inhibitor or abatacept, was added. RA remission was noted in 31 (42%) patients at 18 months of treatment. Results and discussion. The investigation included 74 patients with early RA; whose median (Me) age was 56 years, all the patients had moderate or high disease activity (Me DAS28-ESR, 5.4). At baseline, there was increased CA IMT in 51.4% of cases and CAA in 55.4%. At 18 months of treatment, there were no significant IMT changes. New CA ASPs were recorded in 8 (24.2%) patients who had no CAA at the time of inclusion in the investigation (p < 0.05). Nineteen (46.3%) patients were recorded to have the progression that had been identified when including CAA as a considerable increase in the number of ASPs (p < 0.05). The risk of CAA progression was correlated inversely with the mean 18-month level of high-density lipoprotein cholesterol (HDL-Cmean) and directly with the mean concentration of C-reactive protein (CRPmean). There was no significant correlation between HDL-Cmean and CRPmean. The changes of CAA were unassociated with the value of DAS28-ESR, the achievement of RA remission, and antirheumatic therapy (MTX monotherapy, MTX + BA). Conclusion. CAA shows progress in patients with early RA despite they are treated to target. DAS28-ESR remission in RA and ongoing RA treatment option had no substantial impact on the course of CAA. HDL-Cmean and CRPmean are independent risk factors for progression of CAA. |
| format | Article |
| id | doaj-art-91c02c5ffd164a379cb6be690fcd330d |
| institution | Kabale University |
| issn | 1995-4484 1995-4492 |
| language | Russian |
| publishDate | 2018-09-01 |
| publisher | IMA PRESS LLC |
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| series | Научно-практическая ревматология |
| spelling | doaj-art-91c02c5ffd164a379cb6be690fcd330d2025-08-20T03:37:53ZrusIMA PRESS LLCНаучно-практическая ревматология1995-44841995-44922018-09-0156444945510.14412/1995-4484-2018-449-4552382PROGRESSION OF CAROTID ARTERY ATHEROSCLEROSIS DURING TREATMENT TO TARGET IN PATIENTS WITH EARLY RHEUMATOID ARTHRITISE. V. Udachkina0D. S. Novikova1T. V. Popkova2I. G. Kirillova3E. I. Markelova4Yu. N. Gorbunova5D. E. Karateev6E. L. Luchikhina7N. V. Demidova8M. A. Borisova9G. V. Lukina10S. I. Glukhova11A. V. Volkov12V.A. Nasonova Research Institute of Rheumatology, MoscowV.A. Nasonova Research Institute of Rheumatology, MoscowV.A. Nasonova Research Institute of Rheumatology, MoscowV.A. Nasonova Research Institute of Rheumatology, MoscowV.A. Nasonova Research Institute of Rheumatology, MoscowV.A. Nasonova Research Institute of Rheumatology, MoscowM.F. Vladimirsky Moscow Regional Research Clinical Institute, MoscowM.F. Vladimirsky Moscow Regional Research Clinical Institute, MoscowV.A. Nasonova Research Institute of Rheumatology, MoscowV.A. Nasonova Research Institute of Rheumatology, MoscowV.A. Nasonova Research Institute of Rheumatology, MoscowV.A. Nasonova Research Institute of Rheumatology, MoscowV.A. Nasonova Research Institute of Rheumatology, MoscowRheumatoid arthritis (RA) is a disease with a high cardiovascular risk. The results of works on the impact of antirheumatic therapy on carotid artery (CA) intima-media thickness (IMT) are contradictory. Objective: to assess the time course of changes in CA IMT and CA atherosclerosis (CAA) in patients with early RA during treatment to target at a 18-month follow-up. Subjects and methods. The investigation enrolled patients with early RA (disease duration of less than 12 months), who had not previously taken disease-modifying antirheumatic drugs and glucocorticoids. Duplex scanning (DS) of the CA was performed with IMT measurement at baseline and at 18 months after treatment. Vascular atherosclerotic lesion was recorded when atherosclerotic plaque (ASP) was detected. Starting methotrexate (MTX) monotherapy was prescribed to all the patients, when it showed an insufficient effect at 3 months, a biological agent (BA), such as a tumor necrosis factor-α inhibitor or abatacept, was added. RA remission was noted in 31 (42%) patients at 18 months of treatment. Results and discussion. The investigation included 74 patients with early RA; whose median (Me) age was 56 years, all the patients had moderate or high disease activity (Me DAS28-ESR, 5.4). At baseline, there was increased CA IMT in 51.4% of cases and CAA in 55.4%. At 18 months of treatment, there were no significant IMT changes. New CA ASPs were recorded in 8 (24.2%) patients who had no CAA at the time of inclusion in the investigation (p < 0.05). Nineteen (46.3%) patients were recorded to have the progression that had been identified when including CAA as a considerable increase in the number of ASPs (p < 0.05). The risk of CAA progression was correlated inversely with the mean 18-month level of high-density lipoprotein cholesterol (HDL-Cmean) and directly with the mean concentration of C-reactive protein (CRPmean). There was no significant correlation between HDL-Cmean and CRPmean. The changes of CAA were unassociated with the value of DAS28-ESR, the achievement of RA remission, and antirheumatic therapy (MTX monotherapy, MTX + BA). Conclusion. CAA shows progress in patients with early RA despite they are treated to target. DAS28-ESR remission in RA and ongoing RA treatment option had no substantial impact on the course of CAA. HDL-Cmean and CRPmean are independent risk factors for progression of CAA.https://rsp.mediar-press.net/rsp/article/view/2590carotid artery atherosclerosisduplex scanning of carotid arteriesearly rheumatoid arthritistreat to target strategyinflammation |
| spellingShingle | E. V. Udachkina D. S. Novikova T. V. Popkova I. G. Kirillova E. I. Markelova Yu. N. Gorbunova D. E. Karateev E. L. Luchikhina N. V. Demidova M. A. Borisova G. V. Lukina S. I. Glukhova A. V. Volkov PROGRESSION OF CAROTID ARTERY ATHEROSCLEROSIS DURING TREATMENT TO TARGET IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS Научно-практическая ревматология carotid artery atherosclerosis duplex scanning of carotid arteries early rheumatoid arthritis treat to target strategy inflammation |
| title | PROGRESSION OF CAROTID ARTERY ATHEROSCLEROSIS DURING TREATMENT TO TARGET IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS |
| title_full | PROGRESSION OF CAROTID ARTERY ATHEROSCLEROSIS DURING TREATMENT TO TARGET IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS |
| title_fullStr | PROGRESSION OF CAROTID ARTERY ATHEROSCLEROSIS DURING TREATMENT TO TARGET IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS |
| title_full_unstemmed | PROGRESSION OF CAROTID ARTERY ATHEROSCLEROSIS DURING TREATMENT TO TARGET IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS |
| title_short | PROGRESSION OF CAROTID ARTERY ATHEROSCLEROSIS DURING TREATMENT TO TARGET IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS |
| title_sort | progression of carotid artery atherosclerosis during treatment to target in patients with early rheumatoid arthritis |
| topic | carotid artery atherosclerosis duplex scanning of carotid arteries early rheumatoid arthritis treat to target strategy inflammation |
| url | https://rsp.mediar-press.net/rsp/article/view/2590 |
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