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Changes in cerebral blood flow in rheumatology patients treated with rituximab

Yıl 2018, Cilt: 4 Sayı: 4, 362 - 365, 04.10.2018
https://doi.org/10.18621/eurj.346321

Öz

Objective: We
aimed to assess the effects of rituximab therapy on cerebral hemodynamics  in rheumatic patients with transcranial
Doppler (TCD) ultrasonography. 

Methods: The study included seven patients aged 20-65 years
(2 patients with secondary interstitial lung involvement to rheumatoid
arthritis, 3 patients with systemic lupus erythematosus and lupus nephritis, 2
patients with scleroderma and secondary interstitial lung disease) who received
rituximab treatment due to rheumatic diseases. Healthy control group
(non-rheumatic group) consisted of seven age and sex-matched, randomly selected
persons did not have risk factors for atherosclerosis. Bilateral middle
cerebral artery peak-systolic, end-diastolic, and mean blood flow velocities,
Gosling’s pulsatility index values, and Pourcelot’s resistance index values
were recorded with TCD by a neurosonologist before rituximab
administration. Control TCD performed to the rheumatic group after six months
from the last rituximab dosage. 

Results: One patient was
male and six patients were female. Peak-systolic, end-diastolic and mean blood
flow velocities of rheumatic patients were significantly higher than healthy
group (p < 0.001). Peak-systolic,
end-diastolic and mean blood flow velocities of rheumatic patients were
significantly decreased after rituximab therapy (p < 0.001).

Conclusions: This study
highlights that
the increased cerebral blood flow is indirectly
associated with atherosclerosis regarding persistent inflammation in patients
with rheumatic diseases. It was thought that treatment with rituximab could
reverse this situation. 

Kaynakça

  • [1] Ross R. Atherosclerosis -- an inflammatory disease. N Engl J Med 1999;340:115-26.
  • [2] Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation 2002;105:1135-43.
  • [3] Selmi C, Generali E, Massarotti M, Bianchi G, Sciré CA. New treatments for inflammatory rheumatic disease. Immunol Res 2014;60:277-88.
  • [4] Yüksel S, Ayvazyan L, Gasparyan AY. Familial mediterranean fever as an emerging clinical model of atherogenesis associated with low-grade inflammation. Open Cardiovasc Med J 2010;23:4:51-6.
  • [5] Lin CW, Huang YP, Chiu YH, Ho YT, Pan SL. Increased risk of ischemic stroke in young patients with ankylosing spondylitis: a population-based longitudinal follow-up study. PloS One 2014;9:e94027.
  • [6] Kerekes G, Soltesz P, Der H, Veres K, Szabo Z, Vegvari A, et al. Effects of biologics on vascular function and atherosclerosis associated with rheumatoid arthritis. Ann N Y Acad Sci 2009;1173:814-21.
  • [7] Szekanecz Z, Kerekes G, Soltesz P. Vascular effects of biologic agents in RA and spondyloarthropathies. Nat Rev Rheumatol 2009;5:677-84.
  • [8] Provan SA, Berg IJ, Hammer HB, Mathiessen A, Kvien TK, Semb AG. The impact of newer biological disease modifying anti-rheumatic drugs on cardiovascular risk factors: a 12-month longitudinal study in rheumatoid arthritis patients treated with rituximab, abatacept and tociliziumab. PloS One 2015;10:e0130709.
  • [9] Mathieu S, Pereira B, Dubost JJ, Lusson JR, Soubrier M. No significant changes in arterial stiffness in RA after 6 months and 1 year of rituximab treatment. Rheumatology (Oxford) 2012;51:1107-11.
  • [10] de Riva N., Budohoski KP, Smielewski P, Kasprowicz M, Zweifel C, Steiner LA, et al. Transcranial Doppler pulsatility index: what it is and what it isn’t. Neurocrit Care 2012;17:58-66.
  • [11] Bos MJ, Koudstaal PJ, Hofman A, Witteman JC, Breteler MM. Transcranial Doppler hemodynamic parameters and risk of stroke: the Rotterdam study. Stroke 2007;38:2453-8.
Yıl 2018, Cilt: 4 Sayı: 4, 362 - 365, 04.10.2018
https://doi.org/10.18621/eurj.346321

Öz

Kaynakça

  • [1] Ross R. Atherosclerosis -- an inflammatory disease. N Engl J Med 1999;340:115-26.
  • [2] Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation 2002;105:1135-43.
  • [3] Selmi C, Generali E, Massarotti M, Bianchi G, Sciré CA. New treatments for inflammatory rheumatic disease. Immunol Res 2014;60:277-88.
  • [4] Yüksel S, Ayvazyan L, Gasparyan AY. Familial mediterranean fever as an emerging clinical model of atherogenesis associated with low-grade inflammation. Open Cardiovasc Med J 2010;23:4:51-6.
  • [5] Lin CW, Huang YP, Chiu YH, Ho YT, Pan SL. Increased risk of ischemic stroke in young patients with ankylosing spondylitis: a population-based longitudinal follow-up study. PloS One 2014;9:e94027.
  • [6] Kerekes G, Soltesz P, Der H, Veres K, Szabo Z, Vegvari A, et al. Effects of biologics on vascular function and atherosclerosis associated with rheumatoid arthritis. Ann N Y Acad Sci 2009;1173:814-21.
  • [7] Szekanecz Z, Kerekes G, Soltesz P. Vascular effects of biologic agents in RA and spondyloarthropathies. Nat Rev Rheumatol 2009;5:677-84.
  • [8] Provan SA, Berg IJ, Hammer HB, Mathiessen A, Kvien TK, Semb AG. The impact of newer biological disease modifying anti-rheumatic drugs on cardiovascular risk factors: a 12-month longitudinal study in rheumatoid arthritis patients treated with rituximab, abatacept and tociliziumab. PloS One 2015;10:e0130709.
  • [9] Mathieu S, Pereira B, Dubost JJ, Lusson JR, Soubrier M. No significant changes in arterial stiffness in RA after 6 months and 1 year of rituximab treatment. Rheumatology (Oxford) 2012;51:1107-11.
  • [10] de Riva N., Budohoski KP, Smielewski P, Kasprowicz M, Zweifel C, Steiner LA, et al. Transcranial Doppler pulsatility index: what it is and what it isn’t. Neurocrit Care 2012;17:58-66.
  • [11] Bos MJ, Koudstaal PJ, Hofman A, Witteman JC, Breteler MM. Transcranial Doppler hemodynamic parameters and risk of stroke: the Rotterdam study. Stroke 2007;38:2453-8.
Toplam 11 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Original Article
Yazarlar

Uygar Utku 0000-0003-1280-4754

Gözde Çetin Bu kişi benim 0000-0001-9680-7535

Nurhan Atilla Bu kişi benim 0000-0003-4127-4924

Yayımlanma Tarihi 4 Ekim 2018
Gönderilme Tarihi 24 Ekim 2017
Kabul Tarihi 22 Ocak 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 4 Sayı: 4

Kaynak Göster

AMA Utku U, Çetin G, Atilla N. Changes in cerebral blood flow in rheumatology patients treated with rituximab. Eur Res J. Ekim 2018;4(4):362-365. doi:10.18621/eurj.346321

e-ISSN: 2149-3189 


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