Activation of inflammation, coagulation and fibrinolysis in patients with Rheumatoid Arthritis : inhibition by Tumor Necrosis Factor alpha blockade
Poster
Data di Pubblicazione:
2008
Citazione:
Activation of inflammation, coagulation and fibrinolysis in patients with Rheumatoid Arthritis : inhibition by Tumor Necrosis Factor alpha blockade / F.A. Ingegnoli, F. Fantini, E.G. Favalli, V. Galbiati, A. Soldi, S. Griffini, E. Bonanni, M. Cugno. - In: ANNALS OF THE RHEUMATIC DISEASES. - ISSN 0003-4967. - 67:Suppl.1(2008), pp. A30-A30. ((Intervento presentato al 28. convegno European workshop for rheumatology research tenutosi a Toulouse nel 2008.
Abstract:
Objective: Rheumatoid arthritis (RA) is associated with increased
cardiovascular risk and activation of inflammation and coagulation
pathways. Its treatment with infliximab, a chimeric monoclonal
antibody to tumour necrosis factor-a (TNF-a), reduces inflammation,
but its effects on coagulation and fibrinolysis are unknown.
We therefore investigated plasma biomarkers of inflammation,
coagulation and fibrinolysis before and after infliximab treatment in
RA patients.
Methods: We studied 18 patients with active RA and 36 healthy
controls. RA patients, receiving a stable dose of methotrexate
(10 mg/week), were treated with infliximab (3 mg/kg) at week 0, 2,
6 and 14. At baseline and at week 14, we determined: disease
activity score (DAS28), visual analogue scale (VAS) pain, erythrocyte
sedimentation rate (ESR), and plasma levels of C-reactive
protein (CRP), TNF-a, IL-6, prothrombin fragment 1+2 (F1+2) and
D-dimer. In six patients, we also evaluated inflammation and
coagulation parameters one hour after infliximab infusion.
Results: At baseline, ESR, CRP, TNF-a and IL-6 levels were
significantly higher in the RA patients (p=0.001–p=0.0001), as
were F1+2 and D-dimer levels (p=0.0001). After 14 weeks of
infliximab treatment, there was a significant clinical improvement
(decrease in DAS28, VAS pain, number of swollen and tender
joints) and a significant decrease in ESR and CRP, IL-6, F1+2 and Ddimer
levels (p=0.03–p=0.003). The levels of TNF-a, IL-6, F1+2
and D-dimer significantly decreased one hour after infliximab
infusion (p=0.05–p=0.008).
Conclusions: In RA patients, infliximab leads to a rapid clinical
improvement and a decrease in inflammation and coagulation
biomarkers. The reduction in the latter suggests that it may reduce
thrombotic risk.
Tipologia IRIS:
01 - Articolo su periodico
Elenco autori:
F.A. Ingegnoli, F. Fantini, E.G. Favalli, V. Galbiati, A. Soldi, S. Griffini, E. Bonanni, M. Cugno
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