Patient number Type of study Treatment Surrogate markers Results
Statin          
Van Doornum et al. [74] N=29 Age=55 Prospective observational Atorvastatin 20mg daily for 12 weeks AI AI improved 34.130.6% (P<0.01)
Mäki-Petäjä et al. [75] N=20 Age=58 Prospective observational Simvastatin 20mg or ezetimib 10mg daily, each for 6 weeks PWV FMD PWV and FMD significantly improved by both medications.
Hermann et al. [76] N=20 Age=57 Double blind randomized Simvastatin 40mg daily for 4 weeks FMD FMD improves in patients with statin compared with placebo 5.5% vs. 3.8% (P=0.02)
Biologics therapy          
Hürlimann et al. [88] N=11 Age=46 Post-hoc analysis from a randomized controlled trial Infliximab for 12 weeks FMD FMD improved from 3.2%4.1% (P=0.02)
Wong et al. [89] N=26 Prospective observational Infliximab for 54 weeks PWV cIMT PWV significantly improved but not cIMT
Van Doornum et al. [91] N=14 Age=55 Prospective observational Etanercept (N=7) Adalimumab (N=6) IFx (N=1) for 6 weeks AI AI remained unchanged 29.1% 30.1% (P=0.50)
Tam et al. [93] N=40 Age=53 Randomized open-label study MTx Alone (N=20) MTx + IFx (N=20) for 6 month AI PWV MTx + early IFX improved PWV than MTx alone in early RA patients with active disease.
Mäki-Petäjä et al. [94] N=17 Age=58 Prospective observational Adalimumab (N=12) Etanercept (N=5) in 8 weeks 18F-FDG-PET Reduction in TBRmax from 2.02 to 1.90 (P=0.03)
Protogerou et al. [96] N=16 Age=44 Prospective observational Tocilizumab for 6 months PWV FMD FMD improved from 3.3% 5.2%. PWV decreased from 8.2 m/s 7.0 m/s
Kerekes et al. [99] N=5 Age=42 Prospective observational Rituximab for 2 doses cIMT FMD cIMT improved in 3/5 patients by 16 weeks FMD improved in 4/5 patients by 16 weeks
Abbreviations: 18F-FDG-PET = 18F-fluorodeoxyglucose positron emission tomography; AI = arterial stiffiness; ccIMT= carotid intima media thickness; FMD = flow mediated dilatation; IFx =Infliximib; MTx = Methotrexate, TBRmax = arterial maximum target-to-background ratio
Table 1: The effect of statin and biologics therapy to prevent premature atherosclerosis in patients with rheumatoid arthritis.