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Effects of Biologics on Vascular Function and Atherosclerosis Associated with Rheumatoid Arthritis
Author(s) -
Kerekes György,
Soltész Pál,
Dér Henriett,
Veres Katalin,
Szabó Zoltán,
Végvári Anikó,
Shoenfeld Yehuda,
Szekanecz Zoltán
Publication year - 2009
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.2009.04645.x
Subject(s) - medicine , etanercept , rheumatoid arthritis , infliximab , adalimumab , dyslipidemia , endothelial dysfunction , tumor necrosis factor alpha , inflammation , immunology , disease
Endothelial dysfunction and accelerated atherosclerosis lead to increased cardiovascular morbidity and mortality in rheumatoid arthritis (RA). Sustained inflammation is a major risk factor. Apart from traditional vasculoprotective agents, biologics may also exert favorable effects on the vasculature. Indeed, tumor necrosis factor‐α (TNF‐α) inhibitors agents may transiently improve endothelial function. There are conflicting data regarding the effects of biologics on atherosclerosis and arterial stiffness. Infliximab stimulates the number and differentiation of endothelial progenitor cells that lead to vascular repair. There may be differences in the effects of TNF blockers on dyslipidemia, as long‐term infliximab therapy may be proatherogenic, while some studies suggest that etanercept and adalimumab may exert beneficial effects on lipids. TNF blockers may decrease the incidence of cardiovascular events in RA. Preliminary data suggest that rituximab may also improve endothelial function and dyslipidemia. Further studies are needed to determine the net effects of biologics on the vasculature.