scholarly journals Reply to: Comment on “effects of 1-year anti-TNF-α therapy on vascular function in rheumatoid arthritis and ankylosing spondylitis” by Cure et al.

2020 ◽  
Vol 40 (3) ◽  
pp. 509-509
Author(s):  
Zoltán Szekanecz
Keyword(s):  
Rheumatoid Arthritis ◽  
Ankylosing Spondylitis ◽  
Vascular Function ◽  
Tnf Α

scholarly journals Effects of 1-year anti-TNF-α therapy on vascular function in rheumatoid arthritis and ankylosing spondylitis

2019 ◽  
Vol 40 (3) ◽  
pp. 427-436 ◽  
Author(s):  
Edit Végh ◽  
György Kerekes ◽  
Anita Pusztai ◽  
Attila Hamar ◽  
Szilvia Szamosi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Ankylosing Spondylitis ◽  
Vascular Function ◽  
Certolizumab Pegol ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Cardiovascular Morbidity And Mortality ◽  
Tnf Α ◽  
Flow Mediated Vasodilation

AbstractAccelerated atherosclerosis, increased cardiovascular morbidity and mortality have been associated with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Vascular function, clinical and laboratory markers and the effects of anti-TNF therapy were assessed in arthritides. Fifty-three 53 patients including 36 RA patients treated with either etanercept (ETN) or certolizumab pegol and 17 AS patients treated with ETN were included in a 12-month follow-up study. Ultrasonography was performed to determine flow-mediated vasodilation (FMD), common carotid intima-media thickness (ccIMT) and arterial pulse-wave velocity (PWV) in all patients. All assessments were performed at baseline and 6 and 12 months after treatment initiation. A significant improvement of brachial artery FMD was observed after 6 months (p = 0.004). A tendency of FMD improvement was also observed after 12 months (p = 0.065). ccIMT did not change throughout the year. PWV significantly improved after 12 months (p = 0.034). Higher baseline ccIMT (p = 0.009) and PWV (p = 0.038) were associated with clinical non-response (cNR) versus response (cR) to biologics. Multiple analysis confirmed the association of baseline ccIMT with age (p = 0.003) and cNR (p = 0.009), as well as that of baseline PWV with age at diagnosis (p = 0.022) and current chest pain (p = 0.004). Treatment itself determined the 12-month changes in FMD (p = 0.020) and PWV (p = 0.007). In a mixed cohort of RA and AS patients, TNF inhibition improved or stabilized vascular pathophysiology. Inflammation may be associated with FMD, while, among others, cNR may influence vascular function.

Antinuclear Antibodies and Lupus-like Manifestations in Rheumatoid Arthritis and Ankylosing Spondylitis Patients at 4 Months' Follow-up After Treatment with Infliximab and Etanercept

2020 ◽  
Vol 16 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Mir Amir Aghdashi ◽  
Mohsen Khadir ◽  
Roshan Dinparasti-Saleh
Keyword(s):  
Rheumatoid Arthritis ◽  
Ankylosing Spondylitis ◽  
Treatment Regimen ◽  
Antinuclear Antibodies ◽  
Clinical Symptoms ◽  
Underlying Disease ◽  
Case Group ◽  
Tnf Α ◽  
The Relationship

Background: Up to 44% of patients treated with infliximab and 7% of patients treated with etanercept reported to have anti-drug antibodies within the first 6 months of treatment. Recently, anti-TNF-α therapies have been reported to be employed in the induction of the druginduced lupus erythematous. Objective: The aim of the present study was to investigate the relationship between anti-TNFα antibodies and various manifestations of lupus erythematous. Methods: We enrolled a total of 56 cases divided into 28 known cases of rheumatoid arthritis and 28 cases of ankylosing spondylitis patients and 56 controls. The case group was divided into 4 groups according to the underlying disease (RA or AS) and treatment regimen (infliximab or etanercept). ANA and anti-dsDNA levels and lupus criteria were assessed at the beginning of the study and 4 months after the initiation of anti-TNFα. Results: 36% and 21% of RA patients treated with infliximab, were ANA and anti-dsDNA positive after 4 months (P=0.003, P=0.025). 28% and 7% of RA patients treated with etanercept, were ANA and anti-dsDNA positive after 4 months (P=0.009, P=0.15). 21% and 7% of AS patients treated with infliximab, were ANA and anti-dsDNA positive, respectively (P=0.025, P=0.15). 14% and 7% of AS patients treated with etanercept, were ANA and anti-dsDNA positive, respectively (P=0.63, P=0.15). Three patients who were positive for auto-antibodies developed three criteria for SLE. Conclusions: Infliximab potentially may increase both ANA and anti-dsDNA levels in rheumatoid arthritis, but only ANA in ankylosing spondylitis patients. In general, clinicians should consider different clinical symptoms of ATIL, which may be present as a lupus-like syndrome similar to idiopathic SLE or classical DIL.

scholarly journals POS1011 PREDICTORS OF ENDOTHELIAL DYSFUNCTION IN ANKYLOSING SPONDYLITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 774.1-774
Author(s):  
A. Syngle ◽  
N. Garg ◽  
I. Verma ◽  
P. Krishan
Keyword(s):  
Oxidative Stress ◽  
Ankylosing Spondylitis ◽  
Endothelial Dysfunction ◽  
Disease Activity ◽  
Vascular Function ◽  
Group Analysis ◽  
Predictive Biomarkers ◽  
Markers Of Inflammation ◽  
Tnf Α ◽  
And Oxidative Stress

Background:Cardiovascular (CV) disease is the leading cause of death in Ankylosing Spondylitis (AS). Chronic systemic inflammation driven endothelial dysfunction leading to accelerated atherosclerosis results in premature mortality. Endothelial dysfunction is potentially treatable hence a therapeutic target. Predictive biomarkers for endothelial dysfunction would allow tailoring therapy to the individual.Objectives:To assess the endothelial dysfunction in AS in context of markers of inflammation and oxidative stress in AS patients.Methods:Sub group–analysis of our previous studies of AS1-3 was carried out and 80 AS patients were compared with 40 healthy controls matched for age and sex that were also part of these studies.2,3 Such analysis had so far not been performed in this cohort. Patients with traditional CV risk factors had been excluded in these studies. Flow-mediated dilatation (FMD), as a measure of endothelial function, was assessed by AngioDefender (Everist Health, Ann Arbor, MI). Inflammatory measures included: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score (ASDAS) in AS. We also assayed markers of inflammation, including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), proinflammatory cytokines (interleukin [IL]-1, IL-6, and tumor necrosis factor [TNF]-α), and endothelial dysfunction, including lipids and nitrite and marker of oxidative stress, TBARS.Results:FMD was significantly lower in AS patients compared with controls [(5.80±0.35% vs. 9.09±0.35%, p≤0.05) reduced by approximately 36%] whereas serum nitrite, TBARS, total cholesterol and LDL levels were significantly higher in AS compared with controls (p≤0.05). Compared with controls, AS patients had significantly high BASDAI, ASDAS and increased concentrations of ESR, CRP, TNF-α, and IL-6. In AS, FMD inversely correlated with ASDAS, CRP (Figure 1A), TNF-α (Figure 1B), nitrite (Figure 1C) and TBARS (Figure 1) and positively correlated with HDL (p≤0.05).Figure 1.Correlation of FMD with CRP, TNF-α, Nitrite and TBARSConclusion:In AS, FMD was impaired, indicating endothelial dysfunction. ASDAS, CRP, TNF-α, nitrite, and TBARS were independent predictors of FMD in AS. AS-related inflammatory mechanisms (TNF-α, IL-6) and markers of vascular function and oxidative stress (CRP, nitrite and TBARS) may all be involved in the development of cardiovascular disease in AS and these predictors could serve as a novel therapeutic targets for preventing CV risk in AS.References:[1]Garg N, Krishan P, Syngle A. Rosuvastatin improves endothelial dysfunction in ankylosing spondylitis. Clin Rheumatol. 2015;34:1065-1071.[2]Verma I, Syngle A, Krishan P, Garg N. Endothelial Progenitor Cells as a Marker of Endothelial Dysfunction and Atherosclerosis in Ankylosing Spondylitis. International Journal of Angiology. 2017;26:36–42.[3]Verma I, Krishan P, Syngle A. Predictors of Atherosclerosis in Ankylosing Spondylitis. Rheumatol Ther. 2015;2(2): 173–182.Disclosure of Interests:None declared.

Efficacy of golimumab in the treatment of ankylosing spondylitis and rheumatoid arthritis (own experience)

2020 ◽  
Vol 5-6 (215-216) ◽  
pp. 24-31
Author(s):  
Madina Murzabayeva ◽  
Keyword(s):  
Rheumatoid Arthritis ◽  
Ankylosing Spondylitis ◽  
Tumor Necrosis Factor ◽  
Tumor Necrosis ◽  
Human Monoclonal Antibody ◽  
Laboratory Data ◽  
Das 28 ◽  
Tnf Α ◽  
Necrosis Factor

Genetic engineering drugs are used to treat rheumatic diseases. Based on the results of multicenter studies, the effectiveness and safety of golimumab, a representative of the group of tumor necrosis factor inhibitors in various categories of patients, was proved.. Purpose of research.To evaluate the effectiveness of golimumab in the treatment of ankylosing spondylitis and rheumatoid arthritis. Material and methods. The efficacy of golimumab was analyzed based on clinical and laboratory data in 7 patients with ankylosing spondylitis and 6 patients with rheumatoid arthritis. These studies are described against the background of a one-year follow-up of patients. Results and discussion. The observation group consisted of 7 patients with ankylosing spondylarthritis (as) and 6 patients with a diagnosis of rheumatoid arthritis. In all patients with (as) at the beginning of the study, the BASDAI index >6 points, and in 5 patients, the ASDASRB index was 3.5±0.45. In 4 patients with the diagnosis (as), the BASFI index was 7±0.67, and in three patients-5±0.3. the BASMI Index in all studied patients revealed pronounced disorders and was 7.5±0.85. Positive dynamics was observed during golimumab therapy. A patient with a high degree of BASDAI activity >6 showed improvement on the 4th injection of golimumab, the Average score of BASDAI and BASFI indices on golimumab was lower by the 20th week, compared with the start of therapy. By the 24th week of therapy, the BASDAI index was down 31%. The follow-up group with the diagnosis of rheumatoid arthritis consisted of 6 patients, including 1 male and 5 female, with an average age of 38±0.5 years. In a male patient, the DAS-28 index was 5.2±0.06, the SDAI index was 27±0.05, and the CDAI index was 23±0.03. In women, the DAS-28 index was 3.8±0.03, and the SDAI index was 19±0.3 in 5 patients, and the CDAI index was 20±0.3. after adding golimumab, the General condition of all patients improved clinically after the second injection, and all indicators of inflammatory activity decreased. Golimumab is a human monoclonal antibody to tumor necrosis factor (TNF)α. The effect of golimumab is due to the binding and neutralization of soluble and membrane-bound forms of TNF)α. TNF)α. it is a cytokine detected in patients with rheumatoid arthritis, ankylosing spondylarthritis. Conclusion. Against the background of the use of golimumab, the clinical effect was noted in the form of complete relief of joint pain and positive dynamics according to the studied laboratory parameters. Keywords: rheumatoid arthritis, ankylosing spondylitis, golimumab, efficacy.

Soluble vascular biomarkers in rheumatoid arthritis and ankylosing spondylitis: effects of one-year anti-TNF-α therapy

2020 ◽  
pp. jrheum.200916
Author(s):  
Anita Pusztai ◽  
Attila Hamar ◽  
Ágnes Horváth ◽  
Katalin Gulyás ◽  
Edit Végh ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Ankylosing Spondylitis ◽  
Oxidized Ldl ◽  
Certolizumab Pegol ◽  
Intima Media Thickness ◽  
Serum Levels ◽  
Urokinase Plasminogen Activator Receptor ◽  
Tnf Α ◽  
One Year ◽  
Vascular Biomarkers

Objective Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have been associated with cardiovascular (CV) disease. The treatment of arthritis by tumour necrosis factor α (TNF- α) inhibitors may decrease the serum concentrations of vascular biomarkers. We determined circulating levels of oxidized LDL (oxLDL)/β2 glycoprotein I (β2GPI) complexes, antibodies to 60 kDa heat shock protein (anti-Hsp60), soluble urokinase plasminogen activator receptor (suPAR) and Brain type natriuretic peptide (BNP) fragment in sera of RA and AS patients undergoing anti-TNF treatment. Methods Fifty-three RA/AS patients were treated with etanercept (ETN) or certolizumab pegol (CZP) for one year. Circulating oxLDL/β2GPI complex (AtherOx®), anti- Hsp60 IgG and BNP8-29 fragment levels were assessed by ELISA. suPAR levels were determined by suPARnostic® Quick Triage test. Flow-mediated vasodilation (FMD), carotid intima-media thickness (IMT) and arterial pulse-wave velocity (PWV) were determined by ultrasound. Results One-year anti-TNF treatment significantly decreased oxLDL/β2GPI levels, as well as suPAR levels in patients with “critically” high suPAR levels at baseline. In RA, BNP levels were higher in seropositive vs seronegative patients. Serum levels of these vascular biomarkers variably correlated with lipids, ACPA, RF and CRP. IMT positively correlated with BNP, PWV with suPAR and anti-Hsp60, while FMD inversely associated with anti-Hsp60. In RM-ANOVA analysis, disease activity supported the effects of anti-TNF treatment on 12-month changes in oxLDL/β2GPI. IMT supported the effects of therapy on changes of anti-Hsp60 and suPAR. Conclusion These biomarkers may be involved in the pathogenesis of atherosclerosis underlying RA/AS. TNF inhibition variably affect the serum levels of oxLDL/β2GPI, suPAR and BNP.

scholarly journals Effects of 1-year anti-TNF-α therapies on bone mineral density and bone biomarkers in rheumatoid arthritis and ankylosing spondylitis

2019 ◽  
Vol 39 (1) ◽  
pp. 167-175 ◽  
Author(s):  
Katalin Gulyás ◽  
Ágnes Horváth ◽  
Edit Végh ◽  
Anita Pusztai ◽  
Ágnes Szentpétery ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Mineral Density ◽  
Ankylosing Spondylitis ◽  
Bone Loss ◽  
Bone Mineral ◽  
Certolizumab Pegol ◽  
Joint Destruction ◽  
Type I ◽  
Mineral Density ◽  
Tnf Α

Abstract Objectives Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have been associated with generalized and localized bone loss. We conducted a comprehensive study using imaging (dual-energy X-ray absorptiometry, DXA) and laboratory biomarkers in order to determine bone health and to study the effects of anti-tumor necrosis factor (TNF) biologics in RA and AS. Patients and methods Thirty-six RA and 17 AS patients undergoing 1-year etanercept (ETN) or certolizumab-pegol (CZP) therapy were studied. Bone density was assessed by DXA at baseline and after 12 months. Serum C-reactive protein (CRP), calcium, phosphate, parathyroid hormone (PTH), vitamin D3, osteocalcin, procollagen type I N-propeptide (P1NP), C-terminal telopeptide (βCTX), osteoprotegerin, sclerostin (SOST), Dickkopf-1 (DKK-1), soluble receptor activator nuclear kappa B ligand (sRANKL), and cathepsin K (cathK) levels were determined at baseline and after 6 and 12 months. Results TNF-α inhibition was clinically effective. Anti-TNF-α halted further bone loss over 1 year. In general, anti-TNF therapy significantly increased P1NP, SOST levels, and the P1NP/βCTX ratios, while decreased DKK-1 and CathK production at different time points in most patient subsets. In the full cohort and in RA, baseline and/or 12-month bone mineral density (BMD) at multiple sites exerted inverse relationships with CRP and βCTX, and positive correlation with SOST. In AS, L2-4 BMD after 1-year biologic therapy inversely correlated with baseline βCTX, while femoral neck BMD rather showed inverse correlations with CRP. Conclusions Anti-TNF therapy slowed down generalized bone loss, in association with clinical improvements, in both diseases. TNF blockade may enhance bone formation and suppress joint destruction. Anti-TNF therapy may act inversely on DKK-1 and SOST. Independent predictors of BMD were SOST and βCTX in RA, whilst CRP in AS.Key Points• One-year anti-TNF therapy halted generalized bone loss in association with clinical improvement in arthritides.• Anti-TNF therapy may inversely act on DKK-1 and SOST.• Independent predictors of BMD were SOST and βCTX in RA, while CRP in AS.

Agreement Between Quantiferon-TB Gold Test and Tuberculin Skin Test in the Identification of Latent Tuberculosis Infection in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis

2009 ◽  
Vol 36 (12) ◽  
pp. 2675-2681 ◽  
Author(s):  
NEVSUN INANC ◽  
SIBEL ZEHRA AYDIN ◽  
SAIT KARAKURT ◽  
PAMIR ATAGUNDUZ ◽  
SULE YAVUZ ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Ankylosing Spondylitis ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
High Rate ◽  
Healthy Controls ◽  
Tnf Α

Objective.To compare the Quantiferon-TB Gold test (QTF-G) with the tuberculin skin test (TST) for the detection of latent tuberculosis infection (LTBI) among patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS), with reevaluation of the patients treated with tumor necrosis factor-α (TNF-α) antagonists in the followup.Methods.The study involved 140 consecutive patients, 82 with RA and 58 with AS. Thirty patients were evaluated with QTF-G for detection of LTBI before and after 6 months of TNF-α antagonist treatment. QTF-G was also performed on 49 healthy controls. QTF-G results were recorded as positive, negative, or indeterminate. A positive TST was defined as ≥ 5 mm for RA and AS.Results.The percentages of positive QTF-G were comparable in RA and AS (37% vs 32%). The rate of positive QTF-G in healthy controls (29%) was also similar to RA and AS. In contrast to QTF-G results, a high rate of TST positivity was observed in AS compared to RA (82% vs 55%; p = 0.02). The total agreement between QTF-G and TST was observed to be 61% (κ = 0.29) in the whole group, 70% (κ = 0.42) in RA, and 49% (κ = 0.14) in AS. After 6 months of treatment with TNF-α antagonists, a high rate of QTF-G change was observed in patients with indeterminate results (23% vs 3%; p = 0.03).Conclusion.The comparable prevalence of LTBI among the study groups according to QTF-G supports the view that QTF-G is less susceptible to external factors than TST. Sequential testing for QTF-G in patients with indeterminate or negative results may also be helpful in discriminating LTBI better.

Sign in / Sign up

Export Citation Format

Share Document