Arterial Stiffness and Anti-Tumor Necrosis Factor-Alpha Therapy in Ankylosing Spondylitis: Results With Long-Term Two Year-Follow-Up

KARAKUCAK, Murat; GÖKMEN, Ferhat; TÜRKYILMAZ KÜÇÜKALİ, Ayşegül; SAHIN, Mursel; Ayar, Ahmet; KIRIŞ, ABDULKADİR; KARACA, Adem

Arterial Stiffness and Anti-Tumor Necrosis Factor-Alpha Therapy in Ankylosing Spondylitis: Results With Long-Term Two Year-Follow-Up

Murat KARAKUCAK, (Karadeniz Teknik Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Trabzon, Türkiye)

Adem KARACA, (Karadeniz Teknik Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Trabzon, Türkiye)

Ferhat GÖKMEN, (Karadeniz Teknik Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Trabzon, Türkiye)

Abdulkadir KIRIŞ, (Karadeniz Teknik Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Trabzon, Türkiye)

Mürsel ŞAHİN, (Karadeniz Teknik Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Trabzon, Türkiye)

Ahmet AYAR, (Karadeniz Teknik Üniversitesi, Tıp Fakültesi, Psikiyatri Anabilim Dalı, Trabzon, Türkiye)

Ayşegül TÜRKYILMAZ KÜÇÜKALİ (Recep Tayyip Erdoğan Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Rize, Türkiye)

Archives of Rheumatology

2 1

Yıl: 2014 Cilt: 29 Sayı: 4 Sayfa Aralığı: 250 - 256 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Arterial Stiffness and Anti-Tumor Necrosis Factor-Alpha Therapy in Ankylosing Spondylitis: Results With Long-Term Two Year-Follow-Up

Öz:

Amaç: Bu prospektif klinik çalışma ankilozan spondilit'de damar sertliği üzerine anti-tümör nekroz faktör-alfa (TNF-α) tedavisinin uzun dönemde etkinliğini değerlendirmeyi amaçlamaktadır. Hastalar ve yöntemler: Toplam 28 aktif ankilozan spondilit hastası (21 erkek, 7 kadın; ort. yaş 33.5±9.5 yıl; dağılım 20-52 yıl) çalışmaya alındı. Hastaların biyolojik tedavi başlangıcından önceki değerleri ve orta dönem (24. hafta) değerlendirilmesi rapor edildi. İleri değerlendirme için başlangıç raporları bulunan hastalarla anti-TNF-α tedavisinden sonraki ikinci yılda iletişime geçildi ve arteriyel sertlikleri nabız dalga hızı ile değerlendirildi. Bulgular: Anti-tümör nekroz faktör-alfa tedavisinden iki yıl sonra, hastaların semptomlarında ve klinik aktivite parametrelerini değerlendiren Bath Ankilozan Spondilit Hastalık Aktivite İndeksi skoru (4.9±0.9, 1.9±0.5 ve 1.8±0.9, p=0.0001), eritrosit sedimentasyon hızı (35.5±23.1 mm/h, 13.8±9.2 mm/h ve 25.0±17.9 mm/h, p=0.0001) ve C-reaktif proteinde (2.1±1.6 ng/dl, 0.4±0.3 ng/dl ve 0.6±0.9 ng/dl p=0.0001) anlamlı düzelmeler olmasına rağmen, arteriyel sertlik parametrelerinde (7.9±1.3 metre/saniye, 7.7±1.3 metre/saniye ve 8.3±1.1 metre/saniye, p=0.620) anlamlı değişiklik gözlemlenmedi. Sonuç: Önceki 24 haftalık değerlendirmeyle uyumlu olarak, ikinci yıldaki takip sonuçları anti-TNF-α tedavisinin ankilozan spondilitli hastalarda arteriyel sertliği düzeltmediğini gösterdi.

Anahtar Kelime:

Konular: Romatoloji

Ankilozan Spondilitte Arteriyel Sertlik ve Anti-Tümör Nekroz Faktör-Alfa Tedavisi: İki yıllık uzun dönem takip sonuçları

Öz:

Objectives: This prospective clinical study aims to evaluate the effectiveness of long-term of anti-tumor necrosis factor-alpha (TNF-a) therapy on arterial stiffness in ankylosing spondylitis. Patients and methods: A total of 28 active ankylosing spondylitis patients (21 males, 7 females; mean age 33.5±9.5 years; range 20 to 52 years) were enrolled. Patients values for before the initiation of biological therapy and mid-term (24 weeks) evaluation were reported. For further evaluation, this initially reported patients were contacted two years after anti-TNF-α therapy, and their arterial stiffness was assessed by using pulse wave velocity. Results: After two years of anti-TNF-α therapy, despite the significant improvements in patients symptoms and clinical activity parameters including Bath Ankylosing Spondylitis Disease Activity Index score (4.9±0.9, 1.9±0.5 and 1.8±0.9, p=0.0001), erythrocyte sedimentation rate (35.5±23.1 mm/h, 13.8±9.2 mm/h and 25.0±17.9 mm/h, p=0.0001), and C-reactive protein (2.1±1.6 ng/dL, 0.4±0.3 ng/dL and 0.6±0.9 ng/dL p=0.0001), no significant difference was observed in arterial stiffness parameters (7.9±1.3 meter/second, 7.7±1.3 meter/second and 8.3±1.1 meter/second, p=0.620). Conclusion: In line with the previous 24-week evaluation, the results at two-year follow-up indicates that anti-TNF-α therapy does not improve arterial stiffness in patients with ankylosing spondylitis.

Anahtar Kelime:

Konular: Romatoloji

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Arnett FC. Ankylosing spondylitis. In: Koopman WJ, editor. Arthritis and Allied Condition. Philadelphia: Lippincott Williams and Wilkins; 2001. p. 1317-18.
2. Karkucak M, Cakırbay H, Capkın E, Topba M, Güler M, Tosun M, et al. The prevalance of ankylosing spondylitis in the eastern Black Sea region of Turkey. Eur J Gen Med 2011;8:40-5.
3. Onen F, Akar S, Birlik M, Sari I, Khan MA, Gurler O, et al. Prevalence of ankylosing spondylitis and related spondyloarthritides in an urban area of Izmir, Turkey. J Rheumatol 2008;35:305-9.
4. Cakır N, Pamuk ÖN, Dervi E, Imeryüz N, Uslu H, Benian Ö, et al. The prevalences of some rheumatic diseases in western Turkey: Havsa study. Rheumatol Int 2012;32:895-908.
5. Lautermann D, Braun J. Ankylosing spondylitis- -cardiac manifestations. Clin Exp Rheumatol 2002;20:S11-5.
6. Papagoras C, Voulgari PV, Drosos AA. Atherosclerosis and cardiovascular disease in the spondyloarthritides, particularly ankylosing spondylitis and psoriatic arthritis. Clin Exp Rheumatol 2013;31:612-20.
7. Gonzalez-Juanatey C, Vazquez-Rodriguez TR, Miranda-Filloy JA, Dierssen T, Vaqueiro I, Blanco R, et al. The high prevalence of subclinical atherosclerosis in patients with ankylosing spondylitis without clinically evident cardiovascular disease. Medicine (Baltimore) 2009;88:358-65.
8. Capkin E, Karkucak M, Kiris A, Durmus I, Karaman K, Karaca A, et al. Anti-TNF-a therapy may not improve arterial stiffness in patients with AS: a 24-week follow-up. Rheumatology (Oxford) 2012;51:910-4.
9. Goh L, Samanta A. Update on biologic therapies in ankylosing spondylitis: a literature review. Int J Rheum Dis 2012;15:445-54.
10. Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006;27:2588-605.
11. Matthews PG, Wahlqvist ML, Marks SJ, Myers KA, Hodgson JM. Improvement in arterial stiffness during hypolipidaemic therapy is offset by weight gain. Int J Obes Relat Metab Disord 1993;17:579-83.
12. Matsuo T, Iwade K, Hirata N, Yamashita M, Ikegami H, Tanaka N, et al. Improvement of arterial stiffness by the antioxidant and anti- inflammatory effects of short-term statin therapy in patients with hypercholesterolemia. Heart Vessels 2005;20:8-12.
13. Capkin E, Kiris A, Karkucak M, Durmus I, Gokmen F, Cansu A, et al. Investigation of effects of different treatment modalities on structural and functional vessel wall properties in patients with ankylosing spondylitis. Joint Bone Spine 2011;78:378-82.
14. van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum 1984;27:361-8.
15. Braun J, Pham T, Sieper J, Davis J, van der Linden S, Dougados M, et al. International ASAS consensus statement for the use of anti-tumour necrosis factor agents in patients with ankylosing spondylitis. Ann Rheum Dis 2003;62:817-24.
16. Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A. A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 1994;21:2286-91.
17. Wilkinson IB, Fuchs SA, Jansen IM, Spratt JC, Murray GD, Cockcroft JR, et al. Reproducibility of pulse wave velocity and augmentation index measured by pulse wave analysis. J Hypertens 1998;16:2079-84.
18. Lehtinen K. Mortality and causes of death in 398 patients admitted to hospital with ankylosing spondylitis. Ann Rheum Dis 1993;52:174-6.
19. Peters MJ, van Eijk IC, Smulders YM, Serne E, Dijkmans BA, van der Horst-Bruinsma IE, et al. Signs of accelerated preclinical atherosclerosis in patients with ankylosing spondylitis. J Rheumatol 2010;37:161-6.
20. Sari I, Okan T, Akar S, Cece H, Altay C, Secil M, et al. Impaired endothelial function in patients with ankylosing spondylitis. Rheumatology (Oxford) 2006;45:283-6.
21. Arnett DK, Evans GW, Riley WA. Arterial stiffness: a new cardiovascular risk factor? Am J Epidemiol 1994;140:669-82.
22. Lekakis JP, Papamichael CM, Cimponeriu AT, Stamatelopoulos KS, Papaioannou TG, Kanakakis J, et al. Atherosclerotic changes of extracoronary arteries are associated with the extent of coronary atherosclerosis. Am J Cardiol 2000;85:949-52.
23. Mathieu S, Joly H, Baron G, Tournadre A, Dubost JJ, Ristori JM, et al. Trend towards increased arterial stiffness or intima-media thickness in ankylosing spondylitis patients without clinically evident cardiovascular disease. Rheumatology (Oxford) 2008;47:1203-7.
24. Braun J, Sieper J. Treatment of rheumatoid arthritis and ankylosing spondylitis. Clin Exp Rheumatol 2009;27:S146-7.
25. Mathieu S, Pereira B, Couderc M, Rabois E, Dubost JJ, Soubrier M. No significant changes in arterial stiffness in patients with ankylosing spondylitis after tumour necrosis factor alpha blockade treatment for 6 and 12 months. Rheumatology (Oxford) 2013;52:204-9.
26. Robinson RF, Nahata MC, Sparks E, Daniels C, Batisky DL, Hayes JR, et al. Abnormal left ventricular mass and aortic distensibility in pediatric dialysis patients. Pediatr Nephrol 2005;20:64-8.
27. Celik T, Iyisoy A, Kursaklioglu H, Turhan H, Cagdas Yuksel U, Kilic S, et al. Impaired aortic elastic properties in young patients with prehypertension. Blood Press Monit 2006;11:251-5.
28. Wang J, Xu J, Zhou C, Zhang Y, Xu D, Guo Y, et al. Improvement of arterial stiffness by reducing oxidative stress damage in elderly hypertensive patients after 6 months of atorvastatin therapy. J Clin Hypertens (Greenwich) 2012;14:245-9.
29. Karkucak M, Capkin E, Alver A, Akyuz A, Kiris A, Ak E, et al. The effect of anti-TNF agent on oxidation status in patients with ankylosing spondylitis. Clin Rheumatol 2010;29:303-7.
30. Stone GW, Maehara A, Lansky AJ, de Bruyne B, Cristea E, Mintz GS, et al. A prospective natural- history study of coronary atherosclerosis. N Engl J Med 2011;364:226-35.

APA	KARAKUCAK M, KARACA A, GÖKMEN F, KIRIŞ A, SAHIN M, Ayar A, TÜRKYILMAZ KÜÇÜKALİ A (2014). Arterial Stiffness and Anti-Tumor Necrosis Factor-Alpha Therapy in Ankylosing Spondylitis: Results With Long-Term Two Year-Follow-Up. , 250 - 256.
Chicago	KARAKUCAK Murat,KARACA Adem,GÖKMEN Ferhat,KIRIŞ ABDULKADİR,SAHIN Mursel,Ayar Ahmet,TÜRKYILMAZ KÜÇÜKALİ Ayşegül Arterial Stiffness and Anti-Tumor Necrosis Factor-Alpha Therapy in Ankylosing Spondylitis: Results With Long-Term Two Year-Follow-Up. (2014): 250 - 256.
MLA	KARAKUCAK Murat,KARACA Adem,GÖKMEN Ferhat,KIRIŞ ABDULKADİR,SAHIN Mursel,Ayar Ahmet,TÜRKYILMAZ KÜÇÜKALİ Ayşegül Arterial Stiffness and Anti-Tumor Necrosis Factor-Alpha Therapy in Ankylosing Spondylitis: Results With Long-Term Two Year-Follow-Up. , 2014, ss.250 - 256.
AMA	KARAKUCAK M,KARACA A,GÖKMEN F,KIRIŞ A,SAHIN M,Ayar A,TÜRKYILMAZ KÜÇÜKALİ A Arterial Stiffness and Anti-Tumor Necrosis Factor-Alpha Therapy in Ankylosing Spondylitis: Results With Long-Term Two Year-Follow-Up. . 2014; 250 - 256.
Vancouver	KARAKUCAK M,KARACA A,GÖKMEN F,KIRIŞ A,SAHIN M,Ayar A,TÜRKYILMAZ KÜÇÜKALİ A Arterial Stiffness and Anti-Tumor Necrosis Factor-Alpha Therapy in Ankylosing Spondylitis: Results With Long-Term Two Year-Follow-Up. . 2014; 250 - 256.
IEEE	KARAKUCAK M,KARACA A,GÖKMEN F,KIRIŞ A,SAHIN M,Ayar A,TÜRKYILMAZ KÜÇÜKALİ A "Arterial Stiffness and Anti-Tumor Necrosis Factor-Alpha Therapy in Ankylosing Spondylitis: Results With Long-Term Two Year-Follow-Up." , ss.250 - 256, 2014.
ISNAD	KARAKUCAK, Murat vd. "Arterial Stiffness and Anti-Tumor Necrosis Factor-Alpha Therapy in Ankylosing Spondylitis: Results With Long-Term Two Year-Follow-Up". (2014), 250-256.

APA	KARAKUCAK M, KARACA A, GÖKMEN F, KIRIŞ A, SAHIN M, Ayar A, TÜRKYILMAZ KÜÇÜKALİ A (2014). Arterial Stiffness and Anti-Tumor Necrosis Factor-Alpha Therapy in Ankylosing Spondylitis: Results With Long-Term Two Year-Follow-Up. Archives of Rheumatology, 29(4), 250 - 256.
Chicago	KARAKUCAK Murat,KARACA Adem,GÖKMEN Ferhat,KIRIŞ ABDULKADİR,SAHIN Mursel,Ayar Ahmet,TÜRKYILMAZ KÜÇÜKALİ Ayşegül Arterial Stiffness and Anti-Tumor Necrosis Factor-Alpha Therapy in Ankylosing Spondylitis: Results With Long-Term Two Year-Follow-Up. Archives of Rheumatology 29, no.4 (2014): 250 - 256.
MLA	KARAKUCAK Murat,KARACA Adem,GÖKMEN Ferhat,KIRIŞ ABDULKADİR,SAHIN Mursel,Ayar Ahmet,TÜRKYILMAZ KÜÇÜKALİ Ayşegül Arterial Stiffness and Anti-Tumor Necrosis Factor-Alpha Therapy in Ankylosing Spondylitis: Results With Long-Term Two Year-Follow-Up. Archives of Rheumatology, vol.29, no.4, 2014, ss.250 - 256.
AMA	KARAKUCAK M,KARACA A,GÖKMEN F,KIRIŞ A,SAHIN M,Ayar A,TÜRKYILMAZ KÜÇÜKALİ A Arterial Stiffness and Anti-Tumor Necrosis Factor-Alpha Therapy in Ankylosing Spondylitis: Results With Long-Term Two Year-Follow-Up. Archives of Rheumatology. 2014; 29(4): 250 - 256.
Vancouver	KARAKUCAK M,KARACA A,GÖKMEN F,KIRIŞ A,SAHIN M,Ayar A,TÜRKYILMAZ KÜÇÜKALİ A Arterial Stiffness and Anti-Tumor Necrosis Factor-Alpha Therapy in Ankylosing Spondylitis: Results With Long-Term Two Year-Follow-Up. Archives of Rheumatology. 2014; 29(4): 250 - 256.
IEEE	KARAKUCAK M,KARACA A,GÖKMEN F,KIRIŞ A,SAHIN M,Ayar A,TÜRKYILMAZ KÜÇÜKALİ A "Arterial Stiffness and Anti-Tumor Necrosis Factor-Alpha Therapy in Ankylosing Spondylitis: Results With Long-Term Two Year-Follow-Up." Archives of Rheumatology, 29, ss.250 - 256, 2014.
ISNAD	KARAKUCAK, Murat vd. "Arterial Stiffness and Anti-Tumor Necrosis Factor-Alpha Therapy in Ankylosing Spondylitis: Results With Long-Term Two Year-Follow-Up". Archives of Rheumatology 29/4 (2014), 250-256.