Clinical significance of brachial flow-mediated dilation in patients with rheumatoid arthritis.
OBJECTIVE
This study aimed to clarify whether different anti-tumor necrosis factor (TNF) drugs can improve endothelial function better than conventional disease-modifying anti-rheumatic drugs (DMARDs) in a series of Japanese patients with rheumatoid arthritis (RA).


METHODS
Twenty-five patients who met the American College of Rheumatology 1987 revised diagnostic criteria for RA were randomly selected for this study. The percentage of brachial flow-mediated dilation (%FMD) and maximum carotid intima-media thickness were examined by ultrasonography.


RESULTS
The %FMD in the group treated with anti-TNF therapy was significantly higher than that in the group treated with DMARDs (P < 0.001). The %FMD was significantly correlated with anti-TNF therapy (r = 0.684, P < 0.001) and Disease Activity Score C-reactive protein (r = -0.404, P < 0.05). Multiple regression analysis revealed that anti-TNF therapy was significantly associated with %FMD (β = 0.684, P < 0.001).


CONCLUSIONS
Anti-TNF therapy may influence endothelial function more than conventional DMARD therapy. Prospective longitudinal studies examining whether anti-TNF therapy was able to improve endothelial function are required.
Department of Sports Medicine and Sports Science, Gifu University Graduate School of Medicine, Gifu, Japan.
Tsuneo
T
Watanabe
Masao
M
Takemura
Masao
M
Sato
Hidetoshi
H
Matsunami
Mitsuru
M
Seishima
Katsuji
K
Shimizu
Toshio
T
Matsuoka
D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology*; D001688:Biological Products / Q000627:therapeutic use; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011237:Predictive Value of Tests; D012039:Regional Blood Flow; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014664:Vasodilation / Q000187:drug effects
D018501:Antirheumatic Agents; D001688:Biological Products; D014409:Tumor Necrosis Factor-alpha
atherosclerosis; brachial flow-mediated dilation; carotid intima-media thickness; rheumatoid arthritis; ultrasonography