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Effects of rituximab treatment on endothelial dysfunction, carotid atherosclerosis, and lipid profile in rheumatoid arthritis

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Abstract

Increased cardiovascular mortality has been associated with rheumatoid arthritis (RA). There have been reports indicating that tumor necrosis factor blockers may exert favorable but transient effects on lipid profile, flow-mediated vasodilation (FMD) of the brachial artery, and common carotid intima–media thickness (ccIMT) in RA. In this study, we assessed the effects of rituximab on FMD, ccIMT, and lipid profile. Five female RA patients received two infusions of 1000 mg rituximab i.v. High-resolution B-mode ultrasound was used to assess brachial FMD and ccIMT. We also determined plasma total cholesterol (TC), HDL-C, LDL-C, and triglyceride (Tg) levels. Assessments were performed at baseline, as well as at weeks 2, 6, and 16 after the first infusion. Rituximab (RTX) treatment resulted in a rapid and sustained improvement in FMD. The mean improvement was 30%, 22%, and 81% at weeks 2, 6, and 16, respectively. RTX had little effect on atherosclerosis within this short period of time; however, we observed 10%, 9%, and 2% decreases in ccIMT at weeks 2, 6, and 16, respectively. RTX therapy resulted in 3–11% decrease in TC, as well as 14–35% increase in HDL-C levels. Two infusions of RTX exerted early and sustained favorable effects on endothelial dysfunction, as well as plasma TC and HDL-C levels. RTX may also decrease ccIMT; however, longer follow-up is needed to assess the prolonged effects of RTX on vascular function and lipid profile in RA patients.

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Acknowledgments

This work was supported by research grants T 048541 (Z. S.) and a Bolyai Research Grant (P.S.).

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Authors and Affiliations

  1. Cardiovascular Unit, Third Department of Medicine, University of Debrecen Medical and Health Science Center, Móricz Zs krt. 22., 4032, Debrecen, Hungary

    György Kerekes, Pál Soltész, Henriett Dér & Katalin Veres

  2. Department of Rheumatology, Institute of Medicine, University of Debrecen Medical and Health Science Center, Móricz Zs krt. 22., 4032, Debrecen, Hungary

    Zoltán Szabó, Anikó Végvári & Zoltán Szekanecz

  3. Autoimmune Research Group, Hungarian Academy of Sciences, Debrecen, Hungary

    Gyula Szegedi

  4. Department of Medicine B and Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel

    Yehuda Shoenfeld

Authors
  1. György Kerekes
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  2. Pál Soltész
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  3. Henriett Dér
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  4. Katalin Veres
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  5. Zoltán Szabó
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  6. Anikó Végvári
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  7. Gyula Szegedi
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  8. Yehuda Shoenfeld
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  9. Zoltán Szekanecz
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Correspondence to Zoltán Szekanecz.

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Kerekes, G., Soltész, P., Dér, H. et al. Effects of rituximab treatment on endothelial dysfunction, carotid atherosclerosis, and lipid profile in rheumatoid arthritis. Clin Rheumatol 28, 705–710 (2009). https://doi.org/10.1007/s10067-009-1095-1

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  • DOI: https://doi.org/10.1007/s10067-009-1095-1

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