Study finds, Tumour necrosis factor inhibitors reduces aorti
Aortic stiffness index (AoSI) has to be considered a proxy outcome measure in patients with rheumatoid arthritis (RA). The aim of this study was to comparatively describe AoSI progression in two groups of RA patients on long-term treatment with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) with or without tumour necrosis factor inhibitors (TNFi).

AoSI was evaluated by Doppler echocardiography at the level of the aortic root, using a 2-D guided M-mode evaluation. Eligible participants were assessed at baseline and after 12 months. Changes in serum lipids, glucose and arterial blood pressure were assessed. All patients who did not change DMARD treatment during follow-up were consecutively selected for this study.

--107 (64 TNFi and 43 csDMARDs) RA patients were included. Most patients were in remission or low disease activity and had some CVD risk factors (45.8% hypertension, 59.8% dyslipidaemia, 45.3% smoking).

--The two groups did not differ significantly for baseline AoSI. Follow-up AoSI was significantly increased from baseline in the csDMARDs group (+1.00%) but not in the TNFi group (+0.15%).

--Patients on TNFi had significantly lower follow-up AoSI from baseline than the csDMARDs group (-1.02%).

--Furthermore, follow-up AoSI was significantly lower in TNFi than in csDMARDs users with an increasing number of CVD risk factors.

Long-term treatment with TNFi in individuals with established RA and multiple CVD risk factors was eventually related with slower progression of aortic stiffness.