title: Methotrexate, Cyclosporine A, and Biologics Protect against Atherosclerosis in Rheumatoid Arthritis.
abstract: BACKGROUND
  The risk of cardiovascular disease is increased in rheumatoid arthritis (RA). A meta-analysis showed increased intima media thickness (IMT) in RA. It has been shown that disease modifying antirheumatic drugs (DMARDs) may influence the progression of atherosclerosis. However, it was suggested that biologics may be more efficient than other DMARDs (including methotrexate--MTX) in protecting against atherosclerosis.
  
  
  OBJECTIVE
  The aim of this study was to assess the influence of different RA characteristics and treatment regimens on IMT and atherosclerotic plaques.
  
  
  METHODS
  317 RA patients and 111 controls were included in the study. IMT was measured in carotid (CIMT) and femoral (FIMT) arteries. Arteries were screened for the presence of plaques.
  
  
  RESULTS
  CIMT, FIMT, and prevalence of plaques were lower in patients treated with methotrexate (MTX) ≥ 20 mg/wk, cyclosporine (CsA), or biologics than in patients treated with lower doses of MTX and other disease modifying antirheumatic drugs. No differences in IMT between patients treated with MTX ≥ 20 mg/wk, biologics, or CsA were found.
  
  
  CONCLUSIONS
  We found a beneficial effect of MTX ≥ 20 mg/wk, biologics, and CsA on atherosclerosis. We do not confirm a stronger influence of biologics on IMT compared with therapeutic doses of MTX.
authors.affiliation: Department of Internal Diseases and Rheumatology, Military Institute of Medicine, Ulica Szaserów 128, 04-141 Warszawa, Poland.
authors.forename: Bartłomiej
authors.identifier: 0000-0001-6311-0475
authors.initials: B
authors.lastname: Kisiel
authors.affiliation: Department of Internal Diseases and Rheumatology, Military Institute of Medicine, Ulica Szaserów 128, 04-141 Warszawa, Poland.
authors.forename: Robert
authors.initials: R
authors.lastname: Kruszewski
authors.affiliation: Department of Internal Diseases and Rheumatology, Military Institute of Medicine, Ulica Szaserów 128, 04-141 Warszawa, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Juszkiewicz
authors.affiliation: Department of Internal Diseases and Rheumatology, Military Institute of Medicine, Ulica Szaserów 128, 04-141 Warszawa, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Raczkiewicz
authors.affiliation: Department of Internal Diseases and Rheumatology, Military Institute of Medicine, Ulica Szaserów 128, 04-141 Warszawa, Poland.
authors.forename: Artur
authors.initials: A
authors.lastname: Bachta
authors.affiliation: Department of Internal Diseases and Rheumatology, Military Institute of Medicine, Ulica Szaserów 128, 04-141 Warszawa, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Tłustochowicz
authors.affiliation: Department of Internal Diseases and Rheumatology, Military Institute of Medicine, Ulica Szaserów 128, 04-141 Warszawa, Poland.
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Staniszewska-Varga
authors.affiliation: Department of Infectious Diseases and Allergology, Military Institute of Medicine, Ulica Szaserów 128, 04-141 Warszawa, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Kłos
authors.affiliation: Department of Radiology, Military Institute of Medicine, Ulica Szaserów 128, 04-141 Warszawa, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Duda
authors.affiliation: Department of Radiology, Military Institute of Medicine, Ulica Szaserów 128, 04-141 Warszawa, Poland.
authors.forename: Romana
authors.initials: R
authors.lastname: Bogusławska-Walecka
authors.affiliation: Department of Medical Genetics, Medical University in Warsaw, Ulica Pawińskiego 3c, 02-106 Warszawa, Poland.
authors.forename: Rafał
authors.initials: R
authors.lastname: Płoski
authors.affiliation: Department of Internal Diseases and Rheumatology, Military Institute of Medicine, Ulica Szaserów 128, 04-141 Warszawa, Poland.
authors.forename: Witold
authors.initials: W
authors.lastname: Tłustochowicz
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000473:pathology; D050197:Atherosclerosis / Q000188:drug therapy* / Q000209:etiology*; D001688:Biological Products / Q000627:therapeutic use*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D016572:Cyclosporine / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products; D016572:Cyclosporine; D008727:Methotrexate