Tocilizumab Improves Arterial Stiffness As Well As Other Biologics with Methotrexate-Resistant Active Rheumatoid Arthritis-An Open Label, Randomized Cohort Multi Center Study
|Kensuke Kume1*, Kanzo Amano1, Susumu Yamada1, Kazuhiko Hatta2, Kuniki Amano3, Hiroyuki Ohta4, Noriko Kuwaba5|
|1Department of rheumatology, Hiroshima Clinic, Hiroshima, Japan|
|2Department of rheumatology, Hatta Clinic, Kure, Japan|
|3Department of rheumatology, Sky Clinic, Hiroshima, Japan|
|4Department of medical research, IGL School, Hiroshima, Japan|
|5Division of medical research, Sanki Clinical link, Hiroshima, Japan|
|Corresponding Author :||Kensuke Kume
Department of rheumatology
Hiroshima clinic, Hiroshima
Japan. 7330032 higashi Kannon
20-16, west ward, Hiroshima city
E-mail: [email protected]
|Received May 01, 2015; Accepted May 13, 2015; Published May 18, 2015|
|Citation: Kume K, Amano K, Yamada S, Hatta K, Amano K, et al. (2015) Tocilizumab Improves Arterial Stiffness As Well As Other Biologics with Methotrexate-Resistant Active Rheumatoid Arthritis-An Open Label, Randomized Cohort Multi Center Study. OMICS J Radiol 4: 186. doi: 10.4172/2167-7964.1000186|
|Copyright: ©2015 Kume K, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Objectives: To compare the effects of tocilizumab (TCZ) plus methotrexate (MTX), etanercept (ETN) plus MTX, and infliximab (IFX) plus MTX, respectively on arterial stiffness in rheumatoid arthritis (RA) patients despite MTX treatment, in an open-label, randomized study.
Methods: 62 RA patients with moderate to severe active disease despite MTX treatment were randomly assigned to receive TCZ plus MTX (n=21), ETN plus MTX (n=21), or IFX plus MTX (n=20). All patients have no previous history of CV. Arterial stiffness was assessed with cardio-ankle vascular index (CAVI) and augmentation index corrected for a heart rate of 75 beats per minute ([email protected]) at baseline and 24 weeks follow-up. Clinical data were collected at regular visits.
Results: The characteristics of each group at baseline were not significantly different. In all groups there was significant attenuation from baseline to 24 weeks follow-up in CAVI(TCZ: p=0.01; ETN: p=0.03; IFX:p=0.02) and in [email protected] (TCZ: p=0.01; ETN: p= 0.03; IFX: p=0.02). There were no significant differences between each group in measures of CAVI (p=0.53) or [email protected] (p=0.55). There were no significant changes in cardiovascular risk factors either within or between groups.
Conclusions: Therapy of TCZ, ETN, or IFX combined with MTX, reduced arterial stiffness in RA patients. These findings suggest that combination therapy to block IL6 with MTX not only reduced RA disease activity but also limited vascular damage in patients with RA by blocking TNF.