The effect of anti TNF alpha (certolizumab) treatment on insulin resistance, lipid parameters and cardiovascular risk in patients with axial spondyloarthritis (ankylosing spondylitis)

Yıl 2022, Cilt: 2 Sayı: 3, 65 - 72, 29.07.2022

Hasan Göğebakan , Gözde Yıldırım Çetin

https://doi.org/10.56016/dahudermj.1146178

Öz

Objectives: To evaluate the effects of certolizumab treatment on insulin resistance (IR), lipid parameters, and cardiovascular (CV) risk in patients with ankylosing spondylitis (AS).
Methods: This prospective study included 80 consecutive patients with AS (52 males, 28 females) and 74 control subjects (48 males, 26 feemales). The AS patients and control group were compared in respect of basal values. All AS patients with active disease were treated with certolizumab. Biochemical profiles were obtained before and after 24 weeks of certolizumab treatment. Homeostatic model assessment-insulin resistance (HOMA-IR) was used to measure IR and the quantitative insulin sensitivity control index (QUICKI) was used to measure insulin sensitivity. The Framingham equation was used to evaluate CV risk factors.
Results: A statistically significant increase was determined in total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) values after 24 weeks of certolizumab treatment. No statistically significant change was determined in the plasma atherogenic index (PAI) and low-density lipoprotein cholesterol (LDL-C) values. A statistically significant decrease was determined in HOMA-IR and an increase in QUICKI. When the Framingham risk scoring was compared with the baseline values, a statistically significant decrease in risk was found at week 24.
Conclusions: Certolizumab therapy was associated with a significant increase in HDL-C, TC, and TG levels without any significant change in PAI and LDL-C, and was determined to increase insulin sensitivity and lower insulin resistance. There was also a significant reduction in SBP and 10-year Framingham risk scores at 24 weeks after the start of certolizumab therapy.

Anahtar Kelimeler

Ankylosing spondylitis, Certolizumab, İnsulin resistance, Framingham risk scoring, Lipid parameters., Ankylosing spondylitis, Certolizumab, İnsulin resistance, Framingham risk scoring, Lipid parameters.

Kaynakça

• Sieper J, Braun J, Rudwaleit M, Boonen A, Zink A. Ankylosing spondylitis: An overview. In: Annals of the Rheumatic Diseases. Vol 61. BMJ Publishing Group; 2002:431-432. doi:10.1136/ard.61.suppl_3.iii8
• Dean LE, Jones GT, MacDonald AG, Downham C, Sturrock RD, Macfarlane GJ. Global prevalence of ankylosing spondylitis. Rheumatology (Oxford). 2014;53(4):650-657. doi:10.1093/rheumatology/ket387
• Coates LC, Marzo-Ortega H, Bennett AN, Emery P. Anti-TNF Therapy in Ankylosing Spondylitis: Insights for the Clinician. Ther Adv Musculoskelet Dis. 2010;2(1):37-43. doi:10.1177/1759720X09359728
• Castañeda S, Nurmohamed MT, González-Gay MA. Cardiovascular disease in inflammatory rheumatic diseases. Best Pract Res Clin Rheumatol. 2016;30(5):851-869. doi:10.1016/j.berh.2016.10.006
• Azevedo VF, Pecoits-Filho R. Atherosclerosis and endothelial dysfunction in patients with ankylosing spondylitis. Rheumatol Int. 2010;30(11):1411-1416. doi:10.1007/s00296-010-1416-3
• Després J-P, Lamarche B, Mauriège P, et al. Hyperinsulinemia as an Independent Risk Factor for Ischemic Heart Disease. N Engl J Med. 1996;334(15):952-958. doi:10.1056/NEJM199604113341504
• Paolisso G, Valentini G, Giugliano D, et al. Evidence for peripheral impaired glucose handling in patients with connective tissue diseases. Metabolism. 1991;40(9):902-907. doi:10.1016/0026-0495(91)90064-4
• Sidiropoulos PI, Karvounaris SA, Boumpas DT. Metabolic syndrome in rheumatic diseases: Epidemiology, pathophysiology, and clinical implications. Arthritis Res Ther. 2008;10(3):1-9. doi:10.1186/ar2397
• Gonzalez-Gay MA, De Matias JM, Gonzalez-Juanatey C, et al. Anti-tumor necrosis factor-α blockade improves insulin resistance in patients with rheumatoid arthritis. Clin Exp Rheumatol. 2006;24(1):83-86.
• Otten J, Ahrén B, Olsson T. Surrogate measures of insulin sensitivity vs the hyperinsulinaemic- euglycaemic clamp: A meta-analysis. Diabetologia. 2014;57(9):1781-1788. doi:10.1007/s00125-014-3285-x
• Wilson PWF, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97(18):1837-1847. doi:10.1161/01.CIR.97.18.1837
• Ersozlu Bozkirli ED, Bozkirli E, Yucel AE. Effects of infliximab treatment in terms of cardiovascular risk and insulin resistance in ankylosing spondylitis patients. Mod Rheumatol. 2014;24(2):335-339. doi:10.3109/14397595.2013.843752
• Linden S Van Der, Valkenburg HA, Cats A. Evaluation of Diagnostic Criteria for Ankylosing Spondylitis. Arthritis Rheum. 1984;27(4):361-368. doi:10.1002/art.1780270401
• Dobiášová M, Frohlich J. The plasma parameter log (TG/HDL-C) as an atherogenic index: Correlation with lipoprotein particle size and esterification rate inapob-lipoprotein-depleted plasma (FERHDL). Clin Biochem. 2001;34(7):583-588. doi:10.1016/S0009-9120(01)00263-6
• Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412-419. doi:10.1007/BF00280883
• Katz A, Nambi SS, Mather K, et al. Quantitative Insulin Sensitivity Check Index: A Simple, Accurate Method for Assessing Insulin Sensitivity In Humans. J Clin Endocrinol Metab. 2000;85(7):2402-2410. doi:10.1210/jcem.85.7.6661
• Jacobsson LTH, Turesson C, Gülfe A, et al. Treatment with tumor necrosis factor blockers is associated with a lower incidence of first cardiovascular events in patients with rheumatoid arthritis. J Rheumatol. 2005;32(7):1213-1218.
• Dixon WG, Watson KD, Lunt M, et al. Reduction in the incidence of myocardial infarction in patients with rheumatoid arthritis who respond to anti-tumor necrosis factor α therapy: Results from the British Society for Rheumatology Biologics Register. Arthritis Rheum. 2007;56(9):2905-2912. doi:10.1002/art.22809
• Lee JL, Sinnathurai P, Buchbinder R, Hill C, Lassere M, March L. Biologics and cardiovascular events in inflammatory arthritis: A prospective national cohort study. Arthritis Res Ther. 2018;20(1):171. doi:10.1186/s13075-018-1669-x
• Klarenbeek NB, van der Kooij SM, Huizinga TJW, et al. Blood pressure changes in patients with recent-onset rheumatoid arthritis treated with four different treatment strategies: a post hoc analysis from the BeSt trial. Ann Rheum Dis. 2010;69(7):1342-1345. doi:10.1136/ard.2009.124180
• Sandoo A, Panoulas VF, Toms TE, et al. Anti-TNFα therapy may lead to blood pressure reductions through improved endothelium-dependent microvascular function in patients with rheumatoid arthritis. J Hum Hypertens. 2011;25(11):699-702. doi:10.1038/jhh.2011.36
• Heslinga SC, Peters MJ, Ter Wee MM, et al. Reduction of Inflammation Drives Lipid Changes in Ankylosing Spondylitis. J Rheumatol. 2015;42(10):1842-1845. doi:10.3899/jrheum.150193
• Mathieu S, Dubost JJ, Tournadre A, Malochet-Guinamand S, Ristori JM, Soubrier M. Effects of 14 weeks of TNF alpha blockade treatment on lipid profile in ankylosing spondylitis. Jt Bone Spine. 2010;77(1):50-52. doi:10.1016/j.jbspin.2009.05.012
• Uysal KT, Wiesbrock SM, Marino MW, Hotamisligil GS. Protection from obesity-induced insulin resistance in mice lacking TNF- α function. Nature. 1997;389(6651):610-614. doi:10.1038/39335
• Kiortsis DN, Mavridis AK, Vasakos S, Nikas SN, Drosos AA. Effects of infliximab treatment on insulin resistance in patients with rheumatoid arthritis and ankylosing spondylitis. Ann Rheum Dis. 2005;64(5):765-766. doi:10.1136/ard.2004.026534
• Miranda-Filloy JA, Llorca J, Carnero-López B, González-Juanatey C, Blanco R, González-Gay MA. TNF-alpha antagonist therapy improves insulin sensitivity: In non-diabetic ankylosing spondylitis patients. Clin Exp Rheumatol. 2012;30(6):850-855.
• da Silva BSP, Bonfá E, de Moraes JCB, et al. Effects of anti-TNF therapy on glucose metabolism in patients with ankylosing spondylitis, psoriatic arthritis or juvenile idiopathic arthritis. Biologicals. 2010;38(5):567-569. doi:10.1016/j.biologicals.2010.05.003
• Gonzalez-Gay M, Gonzalez-Juanatey C, Garcia-Porrua C, Martin J. Anti-Tumor Necrosis Factor-?? Blockade Improves Insulin Resistance in Patients with Rheumatoid Arthritis.; 2014. Accessed March 4, 2020. https://www.researchgate.net/publication/7238490
• He J, Le DS, Xu X, Scalise M, Ferrante AW, Krakoff J. Circulating white blood cell count and measures of adipose tissue inflammation predict higher 24-h energy expenditure. Eur J Endocrinol. 2010;162(2):275-280. doi:10.1530/EJE-09-0831
• Batista ML, Peres SB, McDonald ME, et al. Adipose tissue inflammation and cancer cachexia: Possible role of nuclear transcription factors. Cytokine. 2012;57(1):9-16. doi:10.1016/j.cyto.2011.10.008
• Lutf A, Hammoudeh M. Weight Gain and Hair Loss during Anti-TNF Therapy. Int J Rheumatol. 2012;2012:593039. doi:10.1155/2012/593039
• Hmamouchi I, Roux C, Paternotte S, Kolta S, Dougados M, Briot K. Early increase of abdominal adiposity in patients with spondyloarthritis receiving anti-tumor necrosis factor-α treatment. J Rheumatol. 2014;41(6):1112-1117. doi:10.3899/jrheum.131150