title: Effects of 6 months of abatacept treatment on aortic stiffness in patients with rheumatoid arthritis.
abstract: BACKGROUND
  Systemic inflammation plays an important role in the increased cardiac risk observed in rheumatoid arthritis (RA). Effective control of inflammation and disease activity may be of benefit in reducing cardiovascular risk in RA patients.
  
  
  OBJECTIVE
  Our study was conducted in patients with active RA to investigate the effects of 24-week abatacept treatment on aortic stiffness measured by pulse wave velocity (PWV).
  
  
  RESULTS
  The study included 21 patients, of whom 17 were females, with a mean age of 65.2±13.7 years. Ten patients had positive rheumatoid factors, 16 positive anti-citrullinated protein antibodies, and 19 presented an erosive form of RA. Sixteen patients were nonresponders to anti-tumor necrosis factor-alpha treatments. After 6 months of abatacept treatment, there was a significant increase in PWV levels (9.8±2.9 versus 8.5±3.9 m/second; P=0.02). A nonsignificant increase in total cholesterol and low-density lipoprotein cholesterol was observed. There was also a significant increase in high-density lipoprotein cholesterol levels, which led to a nonsignificant decrease in atherogenic index. The improvement in disease activity was significant, and there was a decrease of systemic inflammatory parameters, but without reaching statistical significancy. Changes in PWV were significantly correlated with changes in Disease Activity Score on 28 joints based on erythrocyte sedimentation rate (r=0.46; P=0.035) and in high-density lipoprotein cholesterol (r=-0.38; P=0.046). No correlation was observed with changes in C-reactive protein and in other parameters of lipid profile or in steroid dose.
  
  
  CONCLUSIONS
  The worsening of aortic stiffness found after 6 months of abatacept therapy might be due to an insufficient decrease in systemic inflammation.
authors: Department of Rheumatology, Gabriel-Montpied Hospital, Clermont-Ferrand, France ; Faculty of Medicine, University Clermont 1, Clermont-Ferrand, France.
authors: Sylvain
authors: S
authors: Mathieu
authors: Marion
authors: M
authors: Couderc
authors: Baptiste
authors: B
authors: Glace
authors: Bruno
authors: B
authors: Pereira
authors: Anne
authors: A
authors: Tournadre
authors: Jean-Jacques
authors: JJ
authors: Dubost
authors: Martin
authors: M
authors: Soubrier
keywords: arterial stiffness; atherogenic index; cardiovascular risk markers; systemic inflammation