Can achieving minimal disease activity (MDA) prevent progression of subclinical atherosclerosis and arterial stiffness? a two-year prospective cohort study in psoriatic arthritis
Refereed conference paper presented and published in conference proceedings


摘要Background: PsA patients have higher CVD risk due to underlying inflammation.While achieving MDA was associated with articular benefits, its effect on CVD risk remained uncertain

Objectives: To investigate effect of achieving MDA on subclinical atherosclerosis and arterial stiffness

Methods: Subjects without CVD were recruited and received protocolised treatment aiming at MDA for 2 years. High-resolution ultrasound(for subclinical atherosclerosis) and arterial stiffness were assessed yearly. The primary objective was to investigate the effect of achieving MDA(MDA group)at 12 months on the progression of subclinical atherosclerosis(carotid intima-media thickness[IMT] and plaque)over 2 years. Secondary objectives were to compare1)changes in arterial stiffness(branchial-ankle pulse wave velocity[PWV] and augmentation index[AIX])over 2 years between MDA and non-MDA group;2)changes in vascular outcomes in patients who could or could not achieved sustained MDA(sMDA,defined as achievingMDA from month12 to24).Carotid plaque progression was defined as an increase in number/region harbouring plaque compared with baseline

Results: 90 patients [male:52(58%); age: 50±11] were included. At 24 months, 62 (69%)were on csDMARDs, 20 (22%)were on anti-TNF-α and 8 (9%)were on Secukinumab. Proportion of patient achieved MDA increased significantly(baseline:17%;12 months:64%;24 months:69%) after intensive treatment. Vascular outcomes were similar between MDA and non-MDA group (figure 1).41 (46%)patients achieved sMDA. At baseline, a higher prevalence of subjects in the non-sMDA group were smokers, treated with NSAIDS and csDMARDs;fewer subjects were on bDMARDs, and they had higher disease activity compared with the sMDA group. 34 (38%)of them had plaque progression and prevalence was numerically higher in the non-sMDA group[22 (45%)vs 12 (29%), p=0.13]. Using multivariate analysis, achieving sMDA had protective effect on plaque progression[OR=0.27, 95% CI: 0.09 to 0.84, p=0.03]after adjustment of baseline difference(table 1). Achieving sMDA was also related to less progression of total plaque area(TPA),mean and maxIMT,PWV and AIX(table 1)

Conclusions: Effective suppression of inflammation by achieving sustained MDA may prevent subclinical atherosclerosis and arterial stiffness progression in PsA patients
著者T.H. Cheng, Q. Shang, E. K. M. Li, P.C.H. Wong, L.H.P. Tam, T.Y. Zhu, M.M. Chang, J.J.W. Lee, C.K. Wong, A.P.W. Lee, L.S. Tam
會議名稱Annual European Congress of Rheumatology
會議論文集題名Annals of the Rheumatic Diseases - Annual European Congress of Rheumatology
期次Supplement 2
頁次114 - 114

上次更新時間 2021-21-09 於 00:37