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Association of tocilizumab treatment with changes in measures of regional left ventricular function in rheumatoid arthritis, as assessed by cardiac magnetic resonance imaging
Author(s) -
Kobayashi Yasuyuki,
Kobayashi Hitomi,
Giles Jon T.,
Hirano Masaharu,
Nakajima Yasuo,
Takei Masami
Publication year - 2016
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12632
Subject(s) - medicine , tocilizumab , rheumatoid arthritis , magnetic resonance imaging , ventricular function , cardiac magnetic resonance imaging , cardiology , cardiac magnetic resonance , cardiac function curve , radiology , heart failure
Objective The goal of this study was to determine whether the powerful anti‐inflammatory effect of anti‐interleukin‐6 with tocilizumab ( TCZ ) might lead to a reduction in left ventricular ( LV ) dysfunction in patients with rheumatoid arthritis ( RA ). Methods Consecutive RA patients with active disease and healthy control subjects without a clinical diagnosis of cardiovascular disease were enrolled. The RA patients each had inadequate clinical response to non‐biologic disease‐modifying anti‐rheumatic drugs and were prescribed TCZ therapy. All subjects underwent baseline evaluation of LV function, as measured by cardiac magnetic resonance imaging ( CMRI ). Peak systolic regional radial strain (Err, %) was calculated by feature tracking of cine CMRI . After baseline ( BL ) CMRI measurements, treatment with TCZ was initiated, and patients were followed for 52 weeks. We compared peak Err of RA patients at BL and at 52 weeks. Results Thirteen RA patients (mean age 52.6 ± 5.4 years) were assessed at BL and at 52 weeks, and these patients were compared with 10 non‐ RA controls (mean age 55.7 ± 4.6 years). Disease Activity Score of 28 joints – erythrocyte sedimentation rate and Simple Disease Activity Index were significantly lower in RA patients at 52 weeks than at BL . Mean peak Err at BL in RA patients was significantly lower than in normal subjects ( P = 0.03). Mean peak Err was significantly higher at 52 weeks than at BL ( P = 0.028) in RA patients. Conclusion We showed that TCZ was associated with left ventricular dysfunction in RA patients which correlated with a reduction in RA disease activity.