title: A pilot study of endothelial dysfunction and aortic stiffness after interleukin-6 receptor inhibition in rheumatoid arthritis.
abstract: Interleukin (IL)-6 is a pleiotropic proinflammatory cytokine involved in the pathogenesis of both atherosclerosis and rheumatoid arthritis. The role of the IL-6/IL-6 receptor pathway in the documented acceleration of atherosclerosis in rheumatoid arthritis has not been examined. In a non-randomized prospective pilot study we asked whether endothelial dysfunction, defined as impaired flow mediated dilatation (FMD), and aortic stiffness, assessed by pulse wave velocity (PWV) improve after 3 and 6 monthly therapeutic infusions of the anti-IL-6 receptor antibody tocilizumab for active rheumatoid arthritis. We found that FMD increased from 3.3 ± 0.8 to 4.4 ± 1.2 to 5.2 ± 1.9% (p = 0.003), whereas PWV decreased from 8.2 ± 1.2 to 7.7 ± 1.3 to 7.0 ± 1.0m/s (p < 0.001). Whether these beneficial arterial changes are direct effects of the IL-6/IL-6 receptor pathway inhibition, maintained over time and translate into better clinical outcome warrants further studies.
authors.affiliation: First Department of Propaedeutic and Internal Medicine, Athens University Medical School, Laikon Hospital, Ag Thoma 17, 11527 Athens, Greece. aprotog@med.uoa.gr
authors.forename: A D
authors.initials: AD
authors.lastname: Protogerou
authors.forename: E
authors.initials: E
authors.lastname: Zampeli
authors.forename: K
authors.initials: K
authors.lastname: Fragiadaki
authors.forename: K
authors.initials: K
authors.lastname: Stamatelopoulos
authors.forename: C
authors.initials: C
authors.lastname: Papamichael
authors.forename: P P
authors.initials: PP
authors.lastname: Sfikakis
mesh_terms: D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001011:Aorta / Q000187:drug effects* / Q000276:immunology / Q000503:physiopathology; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology; D004334:Drug Administration Schedule; D004548:Elasticity; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000276:immunology / Q000503:physiopathology; D005260:Female; D006115:Greece; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011673:Pulsatile Flow / Q000187:drug effects; D019947:Receptors, Interleukin-6 / Q000037:antagonists & inhibitors* / Q000276:immunology; D013997:Time Factors; D016896:Treatment Outcome; D014664:Vasodilation / Q000187:drug effects
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; C508603:IL6R protein, human; D019947:Receptors, Interleukin-6; C502936:tocilizumab