Infliximab reduces cardiac output in rheumatoid arthritis patients without heart failure

Santos, Rodrigo Cardoso; Figueiredo, Valéria Maria Chaves de; Martins, Luíz Cláudio; Moraes, Carolina de Haro; Quinaglia, Thiago; Boer-Martins, Leandro; Ferreira-Melo, Sílvia Elaine; Yazbek, Michel Alexandre; Bértolo, Manoel Barros; Moreno, Heitor

doi:10.1590/s0104-42302012000600015

Cited by 13 publications

(3 citation statements)

References 26 publications

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“…In a study by Santos et al there was a decrease in cardiac output and stroke volume in RA patients without clinical and echocardiographical evidence of previous cardiac dysfunction 29. On the other hand, Listing et al showed that therapy with anti-TNF-alpha agents is more likely to be beneficial than harmful with regard to the risk of heart failure 30…”

Section: Discussionmentioning

confidence: 99%

Infliximab, an anti-TNF-alpha agent, improves left atrial abnormalities in patients with rheumatoid arthritis: preliminary results : cardiovascular topic

Çetin

Gökhan

Keskin

et al. 2014

CVJA

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SummaryBackgroundRheumatoid arthritis (RA) is associated with increased cardiovascular morbidity and mortality. In the current prospective study, we addressed the impact of RA on left atrial (LA) function and electrical remodelling. Further, we tried to demonstrate the effects of infliximab, an anti-TNFalpha agent, on echocardiographical LA abnormality in RA patients with preserved left ventricular (LV) ejection fraction.MethodsWe compared 38 female RA patients without clinical evidence of heart disease and 30 female controls without RA and clinical evidence of heart disease. Further, we compared RA patients receiving infliximab and increasing doses of prednisolone over a three-month period. At baseline and post treatment, this study assessed (1) LA and LV parameters using conventional and speckle tracking echocardiography (STE), and (2) electrocardiographic P-wave changes.ResultsThe values of C-reactive protein (CRP), isovolumic relaxation time (IVRT), A wave, and deceleration time (DT) were significantly higher in RA patients compared to the control group (p < 0.05), whereas E/E′ and E/A values were found to be lower (p < 0.05) in RA patients. E/E′ values were lower in prednisolone- compared to infliximab-treated patients (p < 0.05). After three months of infliximab and prednisolone treatment, CRP and disease activity score (DAS 28) values decreased in both groups (p < 0.05), and Duke activity status index (DASI) increased (p < 0.05). Maximal left atrial volume index (LAVImax), pre-contraction left atrial volume index (LAVIpreA) and maximum P wave (Pmax) of the RA patients were higher compared to the control group (p < 0.05), whereas LA global strain was found to be lower (p < 0.05). There was no difference in Pmax values between groups before and after the treatment period. E/E′, LAVImax and LAVIpreA values of infliximab-treated patients decreased and LA global strain increased after three months of therapy compared to baseline (p < 0.05). At baseline in both treatment groups, E/E′ and LA global late diastolic strain rate were lower in prednisolone-compared to infliximab-treated patients (p < 0.05).ConclusionThere was echocardiographic LA abnormality in these RA patients. In this patient group there was also a meaningful increase in maximum P wave assessed by electrocardiography. Infliximab therapy for a period of three months improved LA abnormality.

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Section: Discussionmentioning

confidence: 99%

Infliximab, an anti-TNF-alpha agent, improves left atrial abnormalities in patients with rheumatoid arthritis: preliminary results : cardiovascular topic

Çetin

Gökhan

Keskin

et al. 2014

CVJA

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“…Santos и соавт. [31] проанализировали гемодинамические показатели 14 больных РА без сопутствующей сердечной патологии после введения ИНФ. У всех пациентов отмечалось уменьшение ударного объема сердца и повышение АД по сравнению с контрольным введением изотонического раствора натрия хлорида этим же пациентам через 2 нед.…”

Section: Discussionunclassified

Infliximab tolerance in patients with rheumatoid arthritis in real clinical practice

Аронова¹,

Lukina²,

Сигидин³

2020

Naučno-praktičeskaâ revmatologiâ

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Широкий спектр генно-инженерных биологических препаратов, введенных в клиническую ревматологию за последние годы, обусловливает особый интерес к их переносимости. В статье представлены собственные данные авторов, а также обзор зарубежной литературы, посвященной данному вопросу. Цель исследования-проанализировать переносимость инфликсимаба (ИНФ) у больных ревматоидным артритом (РА) в реальной клинической практике. Материал и методы. В анализ было включено 135 больных РА, получавших ИНФ в комбинации с базисными противовоспалительными препаратами или в виде монотерапии. Результаты и обсуждение. Общая переносимость ИНФ была удовлетворительной. Неблагоприятные реакции (НР) отмечались в 28,1% случаев, в том числе у 19 (14,1%) пациентов-серьезные НР, потребовавшие отмены препарата. Заключение. Наилучшая переносимость отмечалась при использовании комбинации ИНФ и метотрексата. Авторы обращают внимание на необходимость врачебного осмотра перед каждым введением препарата. Ключевые слова: биологическая терапия; генно-инженерные биологические препараты; инфликсимаб; ингибиторы фактора некроза опухоли α; неблагоприятные реакции; ревматоидный артрит.

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“…The incidence of myocarditis ranges between 0.0038 and 1.14%, as found in the pharmacovigilance registries and a retrospective analysis of the literature, respectively [58]. The management of these events is based on the use of immunosuppressors, and no role has been reported for the classic cardioprotective agents used for chemotherapy [59][60][61][62][63].…”

Section: Immune-related Cardiovascular Adverse Eventsmentioning

confidence: 99%

Management of Cardiac Toxicity Induced by Chemotherapy

Trapani

Zagami

Nicolò

et al. 2020

JCM

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Cardiotoxicity encompasses a spectrum of adverse cardiological effects experienced by cancer patients during and after receiving antineoplastic treatments. The intersection of cancer care with the management of the multiple comorbid non-communicable diseases carried by patients or related to cancer treatments motivates the need for an integrated and multidisciplinary approach to therapeutic clinical decision-making. This present review aimed to provide a perspective and an update of the current pharmacotherapy approaches for the prevention and management of cardiotoxicity from antiblastic chemotherapy; as such, it addresses myocardial, vascular, and arrhythmic disorders associated to chemotherapy, by navigating the current knowledge and clinical indications in support of the medical interventions. Clinical scenarios of pharmacological interventions take place with patients receiving anthracycline and, by extrapolation, other agents with cardiotoxic potentials and non-chemotherapy agents, including various small molecules and immunotherapy agents. Analysis of these scenarios aims to provide practical evidence-based guidance for the management of drug-induced cardiac dysfunctions. The possible role of new biomarkers for the early recognition of cardiotoxicity is mentioned across the clinical studies, with reference to the pharmacological biomarker-driven interventions delivered. To best inform survivorship care, the management and context of cardio-oncology services are discussed within the broader network of providers and settings of care.

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Infliximab reduces cardiac output in rheumatoid arthritis patients without heart failure

Abstract: Acute infliximab administration decreased cardiac output due to low stroke volume in RA patients without heart disease. The results also demonstrated that, in spite of its negative inotropic effect, infliximab enhanced BP, probably by increasing PVR.

Cited by 13 publications

References 26 publications

Infliximab, an anti-TNF-alpha agent, improves left atrial abnormalities in patients with rheumatoid arthritis: preliminary results : cardiovascular topic

Infliximab, an anti-TNF-alpha agent, improves left atrial abnormalities in patients with rheumatoid arthritis: preliminary results : cardiovascular topic

Infliximab tolerance in patients with rheumatoid arthritis in real clinical practice

Management of Cardiac Toxicity Induced by Chemotherapy

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