J Korean Med Sci.  2016 Feb;31(2):202-207. 10.3346/jkms.2016.31.2.202.

The Effects of Rituximab on Lipids, Arterial Stiffness and Carotid Intima-Media Thickness in Rheumatoid Arthritis

Affiliations
  • 1Department of Instrumental and Ultrasound Diagnostics, V.A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation. diananovikova75@yandex.ru
  • 2Department of Systemic Rheumatic Diseases, V.A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation.
  • 3Department of Early Arthritis, V.A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation.
  • 4Department Immunology and Molecular Biology, V.A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation.
  • 5V.A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation.

Abstract

The aim of the study was to examine lipid profiles, arterial stiffness (AS), carotid intima-media thickness (cIMT), in 55 women with RA without overt cardiovascular disease (capital ES, CyrillicVD) treated with rituximab (RTX).The following parameters were recorded before and 24 weeks after RTX therapy (2 infusions of 500 or 1,000 mg RTX intravenously, fortnightly): plasma total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides, DAS 28-ESR, serum C-reactive protein (CRP), RF IgM, AS (SI - stiffness index, RI - reflection index) by digital volume pulse contour analysis (Micro Medical, UK), and common cIMT by high-resolution B-mode carotid ultrasound. Based on the European League Against Rheumatism (EULAR) criteria, patients were divided into two groups: 1) moderate/good response to RTX therapy after 24 weeks (41 patients, 75%), 2) no response to RTX therapy (14 patients, 25%). Effective RTX therapy resulted in 9% increase in TC, 23% increase in HDL-C and 14% decrease in atherogenic index, 57% decrease in SI and 24% decrease in RI. We observed a 9% decrease of cIMTmax at 24 weeks. The improvement of cardiovascular parameters was accompanied by statistically significant decreases of CRP, ESR, RF IgM and DAS 28 in group 1 (P < 0.05). There were not significant changes in lipid profile, AS parameters, and cIMT in group 2. Two infusions of RTX in case of moderate/good EULAR effect of therapy exerted favorable effects on lipid profile, AS and cIMT in women with RA without overt CVD.

Keyword

Rheumatoid Arthritis; Lipids; Carotid Atherosclerosis; Arterial Stiffness; Rituximab

MeSH Terms

Antirheumatic Agents/*therapeutic use
Arthritis, Rheumatoid/complications/*drug therapy/physiopathology
Biomarkers/blood
C-Reactive Protein/analysis
Cardiovascular Diseases/complications
Carotid Intima-Media Thickness
Cholesterol, HDL/blood
Cholesterol, LDL/blood
Female
Humans
Lipids/*blood
Middle Aged
Rituximab/*therapeutic use
Treatment Outcome
Triglycerides/blood
Vascular Stiffness
Antirheumatic Agents
Biomarkers
C-Reactive Protein
Cholesterol, HDL
Cholesterol, LDL
Lipids
Rituximab
Triglycerides

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