Anti-TNF-Alpha-Adalimumab Therapy Is Associated with Persistent Improvement of Endothelial Function without Progression of Carotid Intima-Media Wall Thickness in Patients with Rheumatoid Arthritis Refractory to Conventional Therapy

摘要

Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with accelerated atherosclerosis and increased incidence of cardiovascular (CV) events [1]. Besides a genetic component [2] and classic (traditional) CV risk factors [3], chronic inflammation plays a pivotal role in the development of atherogenesis in patients with RA [4]. Different validated techniques are currently available to determine subclinical atherosclerosis in patients with rheumatic diseases. Macrovascular endothelial dysfunction, an early stage in atherosclerosis, can be detected by brachial ultrasonogra-phy as the result of impaired flow-mediated endothelium-dependent vasodilatation (FMD). Carotid ultrasound studies are also useful to disclose the presence of subclinical atherosclerosis [5]