The Effect of Treatments for Rheumatoid Arthritis on Endothelial Dysfunction Evaluated by Flow-Mediated Vasodilation in Patients with Rheumatoid Arthritis

Curr Vasc Pharmacol. 2017;15(1):10-18. doi: 10.2174/1570161114666161013113457.

Abstract

Rheumatoid Arthritis (RA) is a chronic inflammatory disease with a potential cardiovascular (CV) risk. Flow-Mediated Vasodilation (FMD) is an ultrasonic method to evaluate endothelial function. RA is a contributor to endothelial dysfunction, a CV risk. Relevant insights on the improvement of the CV outcomes in RA patients may be obtained by a systematic review of trials that investigated the effects of RA treatment on FMD in RA patients. This review found that treatments with antirheumatic drugs and some non-antirheumatic drugs could improve the FMD in RA patients. Treatment with anti-tumour necrosis factor (TNF)-α drugs, including infliximab, etanercept and adalimumab, improved the FMD in RA patients. Treatment with non-anti-TNF-α drugs, including rituximab, anakinra and tocilizumab, also improved the FMD. One trial showed that conventional synthetic Disease-Modifying Antirheumatic Drugs (DMARDs) improved the FMD. Regarding non-antirheumatic drugs, treatment with ramipril, spironolactone and statins/ezetimibe improved the FMD in RA patients. Treatment of advanced glycation endproducts inhibitors improved the FMD in RA patients, while treatment of pioglitazone did not. Overall, treatments for RA improved endothelial dysfunction, as evaluated by FMD, in RA patients. This information may be useful in patient management, although further studies are necessary to establish strategies in relation to endothelial dysfunction among these patients.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Rheumatoid / diagnosis
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / physiopathology
  • Brachial Artery / diagnostic imaging
  • Brachial Artery / drug effects*
  • Brachial Artery / physiopathology
  • Endothelium, Vascular / drug effects*
  • Endothelium, Vascular / physiopathology
  • Female
  • Humans
  • Hyperemia / physiopathology
  • Male
  • Middle Aged
  • Regional Blood Flow
  • Treatment Outcome
  • Vasodilation / drug effects*

Substances

  • Antirheumatic Agents