title: Anti-TNF-α therapy may not improve arterial stiffness in patients with AS: a 24-week follow-up.
abstract: OBJECTIVE
  The availability of new-generation drugs has provided significant success reflected by disease activity markers and clinical status in AS, but controversial reports necessitate further assessment of associated increased risk of cardiovascular burden that might persist. Hence this prospective clinical study evaluated the effectiveness of a 24-week anti-TNF-α therapy on vascular stiffness [pulse wave velocity (PWV)] in AS.
  
  
  METHODS
  A total of 28 active AS patients (21 males, 7 females) were enrolled before the start of biologic therapy. Demographic and clinical characteristics were recorded. Arterial stiffness was assessed using PWV. Patients were evaluated before and 24 weeks after anti-TNF-α therapy.
  
  
  RESULTS
  The mean disease duration was 8.4 (4.9) years. After 24 weeks of anti-TNF-α therapy, despite significant improvements in patients' symptoms and clinical activity parameters, including BASDAI score [4.9 (0.9) vs 1.9 (0.5), P = 0.0001], ESR [35.5 (23.1) vs 13.8 (9.2) mm/h, P = 0.0001) and CRP level [2.1 (1.6) vs 0.4 (0.3) ng/dl, P = 0.0001], no significant change was seen in arterial stiffness parameters [7.9 (1.3) vs 7.7 (1.3) m/s, P = 0.412]. Significant correlation was determined between arterial stiffness and age, systolic blood pressure and high-density lipoprotein cholesterol levels.
  
  
  CONCLUSIONS
  Despite significant improvement in markers of disease activity, anti-TNF-α therapy does not seem to improve arterial stiffness, a significant AS-associated cardiovascular burden. Thus, when treating AS, significant end-points other than DASs should also be considered, and any hidden threat like arterial stiffness should be addressed further.
authors.affiliation: Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Karadeniz Technical University, Medical School, 61080 Trabzon, Turkey. drcapkin@yahoo.com
authors.forename: Erhan
authors.initials: E
authors.lastname: Capkin
authors.forename: Murat
authors.initials: M
authors.lastname: Karkucak
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Kiris
authors.forename: Ismet
authors.initials: I
authors.lastname: Durmus
authors.forename: Kayhan
authors.initials: K
authors.lastname: Karaman
authors.forename: Adem
authors.initials: A
authors.lastname: Karaca
authors.forename: Mehmet
authors.initials: M
authors.lastname: Tosun
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ayar
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001158:Arteries / Q000187:drug effects*; D001783:Blood Flow Velocity / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013167:Spondylitis, Ankylosing / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D059289:Vascular Stiffness / Q000187:drug effects*
chemical_list: D000893:Anti-Inflammatory Agents; D014409:Tumor Necrosis Factor-alpha