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J Immunol Res. 2015;2015:759610. doi: 10.1155/2015/759610. Epub 2015 May 18.

Methotrexate, Cyclosporine A, and Biologics Protect against Atherosclerosis in Rheumatoid Arthritis.

Author information

1
Department of Internal Diseases and Rheumatology, Military Institute of Medicine, Ulica Szaserów 128, 04-141 Warszawa, Poland.
2
Department of Infectious Diseases and Allergology, Military Institute of Medicine, Ulica Szaserów 128, 04-141 Warszawa, Poland.
3
Department of Radiology, Military Institute of Medicine, Ulica Szaserów 128, 04-141 Warszawa, Poland.
4
Department of Medical Genetics, Medical University in Warsaw, Ulica Pawińskiego 3c, 02-106 Warszawa, Poland.

Abstract

INTRODUCTION:

The risk of cardiovascular disease is increased in rheumatoid arthritis (RA). A meta-analysis showed increased intima media thickness (IMT) in RA. It has been shown that disease modifying antirheumatic drugs (DMARDs) may influence the progression of atherosclerosis. However, it was suggested that biologics may be more efficient than other DMARDs (including methotrexate--MTX) in protecting against atherosclerosis.

OBJECTIVES:

The aim of this study was to assess the influence of different RA characteristics and treatment regimens on IMT and atherosclerotic plaques.

PATIENTS AND METHODS:

317 RA patients and 111 controls were included in the study. IMT was measured in carotid (CIMT) and femoral (FIMT) arteries. Arteries were screened for the presence of plaques.

RESULTS:

CIMT, FIMT, and prevalence of plaques were lower in patients treated with methotrexate (MTX) ≥ 20 mg/wk, cyclosporine (CsA), or biologics than in patients treated with lower doses of MTX and other disease modifying antirheumatic drugs. No differences in IMT between patients treated with MTX ≥ 20 mg/wk, biologics, or CsA were found.

CONCLUSIONS:

We found a beneficial effect of MTX ≥ 20 mg/wk, biologics, and CsA on atherosclerosis. We do not confirm a stronger influence of biologics on IMT compared with therapeutic doses of MTX.

PMID:
26090499
PMCID:
PMC4452098
DOI:
10.1155/2015/759610
[Indexed for MEDLINE]
Free PMC Article

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