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Clinical significance of brachial flow-mediated dilation in patients with rheumatoid arthritis




This study aimed to clarify whether different anti-tumor necrosis factor (TNF) drugs can improve endothelial function better than conventional disease-modifying anti-rheumatic drugs (DMARDs) in a series of Japanese patients with rheumatoid arthritis (RA).


Twenty-five patients who met the American College of Rheumatology 1987 revised diagnostic criteria for RA were randomly selected for this study. The percentage of brachial flow-mediated dilation (%FMD) and maximum carotid intima-media thickness were examined by ultrasonography.


The %FMD in the group treated with anti-TNF therapy was significantly higher than that in the group treated with DMARDs (< 0.001). The %FMD was significantly correlated with anti-TNF therapy (r = 0.684, < 0.001) and Disease Activity Score C-reactive protein (r = –0.404, < 0.05). Multiple regression analysis revealed that anti-TNF therapy was significantly associated with %FMD (β = 0.684, < 0.001).


Anti-TNF therapy may influence endothelial function more than conventional DMARD therapy. Prospective longitudinal studies examining whether anti-TNF therapy was able to improve endothelial function are required.