Background/Purpose: Background/ Patients with psoriatic arthritis (PsA) have an increased cardiovascular (CV) risk. We should have strategies for primary cardiovascular prevention in PsA¹⁾. But there is no evidence of CV risk management and arterial stiffness about Tumor necrotic factor (TNF) inhibitors in patients with PsA.
Objective/ To examine the effect of TNF inhibitors on arterial stiffness in conventional synthetic (cs) DMARDs resistant PsA patients in a cohort study design.

Methods: Sixty eight PSA and patients with moderate to severe active disease despite cs DMARDs treatment (disease activity score: DAPSA2) score >14) were received TNF inhibitors plus cs DMARDs. All patients have no previous history of CV. Arterial stiffness was assessed with cardio-ankle vascular index (CAVI, modified pulse wave velocity(PWV)) and augmentation index corrected for a heart rate of 75 beats per minute (AIx@75) at baseline and 24 weeks follow-up. Clinical data were collected at regular visits. CAVI is very similar to pulse wave velocity (PWV), and CAVI measures arterial wall stiffness independent of blood pressure and it is superior to brachial ankle PWV as an index of arterial stiffness.

Results: 58 PsA patients(28 patients adalimumab, and 30 patients infliximabrespectively) were completed this study, Treatment with TNF inhibitors(10.88 ± 1.86 and 9.46　± 1.14 %; p = 0.006), attenuated the CAVI significantly from baseline to 24 weeks follow up. Treatment with TNF inhibitors (36.4 ± 8.6, 32.1 ± 3.8 %; p = 0.008) attenuated the Aix@75 significantly from baseline to 24 weeks follow up. DAPSA score improved significantly from baseline to 24 weeks(17.45　±　6.33, 5.44　±　3.43: p=0.01). There are no significant differences among biologics about CAVI and Aix@75. Surprisingly, improvement of CAVI and AIx@75 were not correlated disease activity at 24 weeks of biologics treatment (CAVI: p=0.91, AIx@75: p=0.88). TNF inhibitors improves arterial stiffness independently of its effects on disease activity, since even in high disease activity (8 cases; DAPSA score >28) is halted.

Conclusion: These findings suggest that combination therapy, TNF inhibitors with cs DMARDs not only reduced PsA disease activity but also limited vascular damage in patients with cs DMARDS resistant active PsA.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/tnf-inhibitors-improves-arterial-stiffness-with-cs-dmards-resistant-active-psoriatic-arthritis-a-cohort-extended-study/