Non-Invasive Assessment of Micro- and Macrovascular Function after Initiation of JAK Inhibitors in Patients with Rheumatoid Arthritis.

Autor: Anyfanti P; Second Medical Department, Hippokration Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece., Angeloudi E; Second Medical Department, Hippokration Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece., Dara A; Fourth Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece., Pagkopoulou E; Fourth Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece., Moysidou GS; Rheumatology-Clinical Immunology Unit, 4th Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, 11527 Athens, Greece., Deuteraiou K; Fourth Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece., Boutel M; Fourth Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece., Bekiari E; Second Medical Department, Hippokration Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece., Doumas M; 2nd Propedeutic Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece., Kitas GD; Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley DY1 2HQ, UK.; School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK., Dimitroulas T; Fourth Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Jazyk: angličtina
Zdroj: Diagnostics (Basel, Switzerland) [Diagnostics (Basel)] 2024 Apr 17; Vol. 14 (8). Date of Electronic Publication: 2024 Apr 17.
DOI: 10.3390/diagnostics14080834
Abstrakt: Background: Janus kinase (JAK) inhibitors constitute a novel class of oral biologic disease-modifying antirheumatic drugs for patients with rheumatoid arthritis (RA). However, their use has been associated with increased risk of major cardiovascular events. We investigated whether treatment with JAK inhibitors exerts significant alterations in the micro- and microvasculature in RA patients.
Methods: Thirteen patients with RA initiating treatment with JAK inhibitors were prospectively studied. Eventually, data from 11 patients who completed the study were analyzed. Procedures were performed at baseline and 3 months after treatment. Nailfold videocapillaroscopy was applied to detect alterations of the dermal capillary network. Participants underwent 24 h ambulatory blood pressure monitoring (Mobil-O-Graph device) for the assessment of blood pressure (both brachial and aortic) and markers of large artery stiffening [pulse wave velocity (PWV), augmentation index] throughout the whole 24 h and the respective day- and nighttime periods. Carotid intima-media thickness was assessed with ultrasound.
Results: Three-month treatment with JAK inhibitors was not associated with any differences in brachial and aortic blood pressure, arterial stiffness, and carotid atherosclerosis, with the only exception of nighttime PWV, which was significantly elevated at follow-up. However, three-month treatment with JAK inhibitors induced significant microvascular alterations and increased the total number of capillaroscopic abnormalities.
Conclusions: Three-month treatment with JAK inhibitors may exert significant effects on microcirculation as assessed with nailfold videocapillaroscopy, whereas macrovascular structure and function appears largely unaffected. Further research toward this direction may add substantial information to the available literature regarding cardiovascular aspects of JAK inhibitors in RA.
Competing Interests: The authors declare no conflicts of interest.
Databáze: MEDLINE
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