Yıl: 2010 Cilt: 10 Sayı: 2 Sayfa Aralığı: 98 - 103 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

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

Öz:
Amaç: Aktif romatoid artriti (RA) olan hastalarda, bir tümör nekroz faktör (TNF)-α antagonisti olan etanerseptin (ENC) endotel fonksiyonları üzerindeki etkinliğini araştırmaktı. Yöntemler: Bu prospektif çalışmaya toplam 21 RA’lı hasta dahil edildi. Bu hastalardan konvansiyonel metotreksat ve prednisolon tedavisine karşın yüksek hastalık aktivitesi devam eden 11 hastaya (8 kadın, 3 erkek ortalama yaş 47.0+10.1 yıl) haftada 2 kez, 25 mg/SC, 12 hafta süreyle ENC tedavisi başlandı (Grup 1). Konvansiyonel tedavi altında olan 10 hasta ise (8 kadın, 2 erkek ortalama yaş 55.0+6.4 yıl) kontrol grubunu oluşturdu (Grup 2). Brakiyal arterin endotel bağımlı ve bağımsız vazodilatasyon yanıtları yüksek rezolüsyonlu ultrason ile değerlendirildi. Eritrosit sedimantasyon hızı (ESH) ve C-reaktif protein (CRP) değerleri bazal ve tedavi sonrası dönemlerde ölçüldü. Verilerin karşılaştırılmasında Mann-Whitney U ve Wilcoxon testleri, korelasyonlar için Pearson korelasyon testi kullanılmıştır. Bulgular: Endotel bağımlı vazodilatasyon ENC grubunda %5.2±0.8’den %7.9±1.3’e yükselirken (p=0.04) kontrol grubunda anlamlı değişiklik saptanmadı (%6.6±1.1’den %7.0±1.8’e p=0.67). Bazal çaplarda ve endotel bağımsız vazodilatasyonda her iki grupta da anlamlı değişiklik gözlenmedi. Etanersept grubunda tedavi sonunda ESR ve CRP değerlerinde anlamlı azalma gözlendi (sırasıyla 16.2±6.8 mm/saat’ten 9.2± 5.1 mm/saat’e, p=0.003 ve 14.68±3.4 mg/L’den 9.25± 3.7 mg/L’ye, p=0.003). Sonuç: Çalışmamızda 12 hafta süreyle uygulanan ENC tedavisinin aktif RA’sı olan hastalarda konvansiyonel tedaviye oranla endotel fonksiyonları anlamlı derecede iyileştirdiği gözlenmiştir. Bu bulgumuz aktif RA’lı hastalarda yüksek oranda gözlenen kardiyovasküler komplikasyonların azaltılması amacıyla TNF- α blokajı yapan ajanların kullanımının faydalı olabileceği yönündeki görüşleri desteklemektedir.
Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Romatoid artrit’li hastalarda etanercept ile yapılan anti-tümör nekroz faktör (TNF)-alfa tedavisinin endotel fonksiyonları üzerine etkisi

Öz:
Objective: To investigate the effects of tumor necrosis factor (TNF)-α antagonism with etanercept (ENC) on endothelial functions in patients with active rheumatoid arthritis (RA). Methods: A total of 21 patients with RA were enrolled in this prospective study. Eleven of them (8 women, 3 men mean age 47.0±10.1 years) with high disease activity despite the conventional treatment were assigned to Group 1 and were given ENC treatment twice a week (25 mg SC injection) for 12 weeks. Ten patients with RA (8 women, 2 men mean age 55.0±6.4 years) under conventional methotrexate and prednisone therapy were assigned as Control group (Group 2). Endothelium-dependent and -independent vasodilator responses of the brachial artery were assessed by high-resolution ultrasound. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were also measured at baseline and at the post treatment period. Mann-Whitney U and Wilcoxon tests were used to compare the data and correlation analysis was performed using Pearson correlation test. Results: Endothelium-dependent vasodilatation improved from 5.2±0.8% to 7.9±1.3% (p=0.04) in ENC group, while no significant change was observed in the control group (from 6.6±1.1% to 7.0±1.8% p=0.67). No significant changes were found in endothelium-independent vasodilatation and baseline brachial artery diameters in both groups. A significant reduction in ESR and CRP were observed in patients receiving ENC (from 16.2±6.8 to 9.2± 5.1 mm/h, p=0.003 and from 14.68±3.4 to 9.25± 3.7 mg/L, p=0.003, respectively). Conclusion: Treatment with ENC for 12 weeks significantly improved endothelial function in patients with active RA compared to those under conventional therapy. The findings of the present study support the hypothesis that the use of TNF-α blockers in patients with active RA may reduce the high incidence of cardiovascular complications.
Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA TIKIZ H, Arslan Ö, PIRILDAR T, TIKIZ C, BAYINDIR P (2010). The effect of anti-tumor necrosis factor (TNF)-alpha therapy with etanercept on endothelial functions in patients with rheumatoid arthritis. , 98 - 103.
Chicago TIKIZ Hakan,Arslan Özlem,PIRILDAR Timur,TIKIZ CANAN,BAYINDIR Petek The effect of anti-tumor necrosis factor (TNF)-alpha therapy with etanercept on endothelial functions in patients with rheumatoid arthritis. (2010): 98 - 103.
MLA TIKIZ Hakan,Arslan Özlem,PIRILDAR Timur,TIKIZ CANAN,BAYINDIR Petek The effect of anti-tumor necrosis factor (TNF)-alpha therapy with etanercept on endothelial functions in patients with rheumatoid arthritis. , 2010, ss.98 - 103.
AMA TIKIZ H,Arslan Ö,PIRILDAR T,TIKIZ C,BAYINDIR P The effect of anti-tumor necrosis factor (TNF)-alpha therapy with etanercept on endothelial functions in patients with rheumatoid arthritis. . 2010; 98 - 103.
Vancouver TIKIZ H,Arslan Ö,PIRILDAR T,TIKIZ C,BAYINDIR P The effect of anti-tumor necrosis factor (TNF)-alpha therapy with etanercept on endothelial functions in patients with rheumatoid arthritis. . 2010; 98 - 103.
IEEE TIKIZ H,Arslan Ö,PIRILDAR T,TIKIZ C,BAYINDIR P "The effect of anti-tumor necrosis factor (TNF)-alpha therapy with etanercept on endothelial functions in patients with rheumatoid arthritis." , ss.98 - 103, 2010.
ISNAD TIKIZ, Hakan vd. "The effect of anti-tumor necrosis factor (TNF)-alpha therapy with etanercept on endothelial functions in patients with rheumatoid arthritis". (2010), 98-103.
APA TIKIZ H, Arslan Ö, PIRILDAR T, TIKIZ C, BAYINDIR P (2010). The effect of anti-tumor necrosis factor (TNF)-alpha therapy with etanercept on endothelial functions in patients with rheumatoid arthritis. Anadolu Kardiyoloji Dergisi, 10(2), 98 - 103.
Chicago TIKIZ Hakan,Arslan Özlem,PIRILDAR Timur,TIKIZ CANAN,BAYINDIR Petek The effect of anti-tumor necrosis factor (TNF)-alpha therapy with etanercept on endothelial functions in patients with rheumatoid arthritis. Anadolu Kardiyoloji Dergisi 10, no.2 (2010): 98 - 103.
MLA TIKIZ Hakan,Arslan Özlem,PIRILDAR Timur,TIKIZ CANAN,BAYINDIR Petek The effect of anti-tumor necrosis factor (TNF)-alpha therapy with etanercept on endothelial functions in patients with rheumatoid arthritis. Anadolu Kardiyoloji Dergisi, vol.10, no.2, 2010, ss.98 - 103.
AMA TIKIZ H,Arslan Ö,PIRILDAR T,TIKIZ C,BAYINDIR P The effect of anti-tumor necrosis factor (TNF)-alpha therapy with etanercept on endothelial functions in patients with rheumatoid arthritis. Anadolu Kardiyoloji Dergisi. 2010; 10(2): 98 - 103.
Vancouver TIKIZ H,Arslan Ö,PIRILDAR T,TIKIZ C,BAYINDIR P The effect of anti-tumor necrosis factor (TNF)-alpha therapy with etanercept on endothelial functions in patients with rheumatoid arthritis. Anadolu Kardiyoloji Dergisi. 2010; 10(2): 98 - 103.
IEEE TIKIZ H,Arslan Ö,PIRILDAR T,TIKIZ C,BAYINDIR P "The effect of anti-tumor necrosis factor (TNF)-alpha therapy with etanercept on endothelial functions in patients with rheumatoid arthritis." Anadolu Kardiyoloji Dergisi, 10, ss.98 - 103, 2010.
ISNAD TIKIZ, Hakan vd. "The effect of anti-tumor necrosis factor (TNF)-alpha therapy with etanercept on endothelial functions in patients with rheumatoid arthritis". Anadolu Kardiyoloji Dergisi 10/2 (2010), 98-103.