The effect of anti-tumor necrosis factor (TNF)-alpha therapy with etanercept on endothelial functions in patients with rheumatoid arthritis

Tıkız, Hakan; Arslan, Oezlem; Pırıldar, Timur; Tıkız, Canan; Bayındır, Petek

doi:10.5152/akd.2010.031

Cited by 12 publications

(7 citation statements)

References 27 publications

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“…Thus the present work represents the most comprehensive systematic literature review and meta-analysis on this topic and summarises the best evidence of the association between endothelial function and use of anti-TNF-α molecules in RA patients. More importantly, our cumulative meta-analysis confirmed several single, positive studies highlighting the potential of anti-TNF-α medications to improve vascular endothelial function 29–32, 34–44, 47, 48, 51, 52 . In particular, Sandoo et al .…”

Section: Discussionsupporting

confidence: 74%

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Anti-TNF-alpha agents and endothelial function in rheumatoid arthritis: a systematic review and meta-analysis

Ursini

Leporini

Bene

et al. 2017

Sci Rep

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Rheumatoid arthritis (RA) has been associated with endothelial dysfunction, a pathophysiological feature of atherosclerosis. Our aim was to determine whether TNF-α blockade has a beneficial effect on endothelial function in RA. We performed a systematic review with meta-analysis to evaluate the effect of anti-TNF-α agents on endothelial function in RA patients. MedLine, Cochrane CENTRAL and SCOPUS were searched up to March 2016. Inclusion criteria were: 1) randomised controlled trial (RCT), quasi-RCT, before-after cohort study; 2) including RA patients; 3) treatment with anti-TNF-α medications; 4) evaluating the change from baseline in endothelial function. The search strategy retrieved 180 records, of which 20 studies were included in the systematic review. Pooled analysis using a random-effects model demonstrated a significant improvement in endothelial function following anti-TNF-α treatment (SDM 0.987, 95%CI [0.64–1.33], p < 0.0001). Generalisation of the results of the meta-analysis may be limited due to the presence of heterogeneity (I2 = 82.65%, p < 0.001) and evidence of possible publication bias. Meta-regression showed that endothelial function measurement technique was a significant contributor to heterogeneity. In conclusion, although limited by the methodological quality of the included studies, our meta-analysis suggests that anti-TNF-α treatment may improve endothelial function in RA patients.

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Section: Discussionsupporting

confidence: 74%

“…Of the included studies, 16 were observational studies 29–44 and only four 45–48 were quasi-controlled trials. Characteristics of the studies included in pooled analysis are reported in Table 1 and Supplementary Table S3.…”

Section: Resultsmentioning

confidence: 99%

Anti-TNF-alpha agents and endothelial function in rheumatoid arthritis: a systematic review and meta-analysis

Ursini

Leporini

Bene

et al. 2017

Sci Rep

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“…For the primary endpoint, FMD values at week 12 were compared between the secukinumab 300 mg group (label dose, group A) and pooled placebo groups (groups C and D) with an analysis of covariance model with factor treatment and covariate baseline value. The sample size calculation of this exploratory study was based on literature findings in changes in FMD in patients with rheumatoid arthritis after treatment with a biologic at week 12 in comparison to baseline (Kerekes et al, 2011;Tikiz et al, 2010). It was estimated that a sample size of 50 patients in groups A and B and 25 in groups C and D (which were pooled for the analyses up to week 12) would result in a power of 90% (on a 5%, two-sided significance level) if the effect size in percent change in FMD were 2.6 (standard deviation, AE 4).…”

Section: Baselinementioning

confidence: 99%

Impact of Secukinumab on Endothelial Dysfunction and Other Cardiovascular Disease Parameters in Psoriasis Patients over 52 Weeks

Stebut

Reich

Thaçi

et al. 2019

Journal of Investigative Dermatology

158

132

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Psoriasis increases the risk of cardiovascular (CV) disease. Secukinumab, a fully human monoclonal antibody against IL-17A, shows significant efficacy in psoriasis, but effects on CV markers are unknown. CARIMA (Evaluation of Cardiovascular Risk Markers in Psoriasis Patients Treated with Secukinumab) was a 52-week, randomized, double-blind, placebo-controlled, exploratory trial in patients with moderate to severe plaque psoriasis without clinical CV disease. Patients were randomly assigned to receive 300 mg or 150 mg secukinumab until week 52 or to receive placebo until week 12 and then 300 mg or 150 mg secukinumab until week 52. The primary outcome was endothelial function measured by flow-mediated dilation (FMD). Baseline FMD was significantly lower in psoriasis patients than healthy volunteers (4.4 AE 3.9% vs. 6.1 AE 3.3%, P ¼ 0.01). At week 12, baseline-adjusted mean FMD was numerically higher in patients receiving secukinumab versus those receiving placebo, but this difference (300-mg group, þ1.2%; 150-mg group, þ0.76%; P ¼ 0.223 and P ¼ 0.403 by analysis of covariance) did not reach significance. At week 52, FMD increased across groups. FMD was significantly higher than baseline in patients receiving the label dose of 300 mg secukinumab for 52 weeks (þ2.1%, 95% confidence interval ¼ 0.8e3.3; P ¼ 0.0022). Other relevant CV markers were unchanged. CARIMA indicates that secukinumab might have a beneficial effect on CV risk by improving the endothelial function of patients with plaque psoriasis.

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“…FMD improved significantly after 12 weeks (p < 0.001). 64 11 RA Etanercept injected subcutaneously at 2 × 25 mg wk -1 for 12 weeks. No controls.…”

Section: Asmentioning

confidence: 99%

Do anti‐tumour necrosis factor‐α biologics affect subclinical measures of atherosclerosis and arteriosclerosis? A systematic review

Knowles

Nadeem

Chowienczyk

2020

Brit J Clinical Pharma

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Aims: Inflammatory cytokines, particularly tumour necrosis factor-α (TNFα), are thought to promote arterial disease through a variety of mechanisms leading to arteriosclerosis and atherosclerosis. We reviewed the existing evidence of the effect of anti-TNFα treatment on arteriosclerosis and atherosclerosis in chronic inflammatory disease. Methods:We performed a systematic review of studies examining effects of monoclonal antibodies against TNFα on subclinical measures of arteriosclerosis (arterial pulse wave velocity) and atherosclerosis (endothelial function measured by flowmediated dilation or forearm blood flow responses to endothelium-dependent agonists, and common carotid intima-media thickness). Results:We identified 60 studies (of 854 potential studies identified using a systematic search) in which effects of anti-TNFα biologics on these measures were assessed in patients receiving anti-TNFα therapy for a clinical indication (usually an inflammatory disease such as an inflammatory arthritis, psoriasis or inflammatory bowel disease). Of these, only 6 were randomised clinical controlled trials. Whilst many observational studies and noncontrolled studies reported positive findings, positive finding were reported in only 1 of 6 randomised clinical controlled trials. Conclusions:There is no strong evidence for an effect of anti-TNFα biologics on the subclinical measures of arteriosclerosis or atherosclerosis examined in this review.This does not exclude a positive effect of TNFα biologics on clinical outcomes through alternate pathways including those induced by remission of the primary inflammatory disease.

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The effect of anti-tumor necrosis factor (TNF)-alpha therapy with etanercept on endothelial functions in patients with rheumatoid arthritis

Cited by 12 publications

References 27 publications

Anti-TNF-alpha agents and endothelial function in rheumatoid arthritis: a systematic review and meta-analysis

Anti-TNF-alpha agents and endothelial function in rheumatoid arthritis: a systematic review and meta-analysis

Impact of Secukinumab on Endothelial Dysfunction and Other Cardiovascular Disease Parameters in Psoriasis Patients over 52 Weeks

Do anti‐tumour necrosis factor‐α biologics affect subclinical measures of atherosclerosis and arteriosclerosis? A systematic review

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