Tocilizumab monotherapy reduces arterial stiffness as effectively as etanercept
or adalimumab monotherapy in rheumatoid arthritis: an open-label randomized
controlled trial.
Author(s): Kume K, Amano K, Yamada S, Hatta K, Ohta H, Kuwaba N.
Affiliation(s): Hiroshima Clinic, Rheumatology, Higashi-Kannon 20-16, Nishi-ku, Hiroshima City,
Hiroshima Prefecture 7330032, Japan. kumekensuke@live.jp
Publication date & source: 2011, J Rheumatol. , 38(10):2169-71
OBJECTIVE: To compare the respective effects of tocilizumab (TCZ) monotherapy,
etanercept (ETN) monotherapy, and adalimumab (ADA) monotherapy on arterial
stiffness in patients with rheumatoid arthritis (RA) in an open-label, randomized
controlled trial.
METHODS: Patients with RA were eligible if they had active disease (28-joint
Disease Activity Score > 3.2) and no prior treatment with methotrexate or
biologics. All 64 patients had no history of cardiovascular disease or steroid
treatment. Patients were randomly assigned to receive TCZ alone (n = 22), ETN
alone (n = 21), or ADA alone (n = 21). Arterial stiffness was assessed with
cardio-ankle vascular index (CAVI) and aortic augmentation index normalized to a
fixed heart rate of 75 bpm (AIx@75) at baseline and 24 weeks' followup. Clinical
data were collected at regular visits.
RESULTS: The characteristics of each group at baseline were not significantly
different. In all groups there was significant attenuation from baseline to 24
weeks in CAVI (Week 0-Week 24, TCZ: 0.85 ± 0.15 m/s, p = 0.02; ETN: 0.81 ± 0.18
m/s, p = 0.03; ADA: 0.90 ± 0.21 m/s, p = 0.02) and in AIx@75. There were no
significant differences among the groups in measures of CAVI or AIx@75. The 3
therapies made no difference to carotid intima-media thickness and carotid artery
plaque. Only TCZ increased fasting serum total cholesterol from baseline to 24
weeks.
CONCLUSION: The 3 types of monotherapy limited arterial stiffness in patients
with RA to a similar extent.
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