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. firstname.lastname@example.org
Publication date & source: 2011-10, J Rheumatol., 38(10):2169-71. Epub 2011 Aug 1.
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.