Anti-TNF-alpha agents and endothelial function in rheumatoid arthritis: a systematic review and meta-analysis

Abstract Rheumatoid arthritis (RA) has been associated with endothelial dysfunction, a pathophysiological feature of atherosclerosis. Our aim was to determine whether TNF-α blockade has a beneficial effect on endothelial function in RA. We performed a systematic review with meta-analysis to evaluate...

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Autores principales:	Francesco Ursini, Christian Leporini, Fabiola Bene, Salvatore D’Angelo, Daniele Mauro, Emilio Russo, Giovambattista De Sarro, Ignazio Olivieri, Costantino Pitzalis, Myles Lewis, Rosa Daniela Grembiale
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/10c5a376fa1a4585b4253aeec2845f48
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spelling	oai:doaj.org-article:10c5a376fa1a4585b4253aeec2845f482021-12-02T12:32:00ZAnti-TNF-alpha agents and endothelial function in rheumatoid arthritis: a systematic review and meta-analysis10.1038/s41598-017-05759-22045-2322https://doaj.org/article/10c5a376fa1a4585b4253aeec2845f482017-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-05759-2https://doaj.org/toc/2045-2322Abstract Rheumatoid arthritis (RA) has been associated with endothelial dysfunction, a pathophysiological feature of atherosclerosis. Our aim was to determine whether TNF-α blockade has a beneficial effect on endothelial function in RA. We performed a systematic review with meta-analysis to evaluate the effect of anti-TNF-α agents on endothelial function in RA patients. MedLine, Cochrane CENTRAL and SCOPUS were searched up to March 2016. Inclusion criteria were: 1) randomised controlled trial (RCT), quasi-RCT, before-after cohort study; 2) including RA patients; 3) treatment with anti-TNF-α medications; 4) evaluating the change from baseline in endothelial function. The search strategy retrieved 180 records, of which 20 studies were included in the systematic review. Pooled analysis using a random-effects model demonstrated a significant improvement in endothelial function following anti-TNF-α treatment (SDM 0.987, 95%CI [0.64–1.33], p < 0.0001). Generalisation of the results of the meta-analysis may be limited due to the presence of heterogeneity (I2 = 82.65%, p < 0.001) and evidence of possible publication bias. Meta-regression showed that endothelial function measurement technique was a significant contributor to heterogeneity. In conclusion, although limited by the methodological quality of the included studies, our meta-analysis suggests that anti-TNF-α treatment may improve endothelial function in RA patients.Francesco UrsiniChristian LeporiniFabiola BeneSalvatore D’AngeloDaniele MauroEmilio RussoGiovambattista De SarroIgnazio OlivieriCostantino PitzalisMyles LewisRosa Daniela GrembialeNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-10 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Francesco Ursini Christian Leporini Fabiola Bene Salvatore D’Angelo Daniele Mauro Emilio Russo Giovambattista De Sarro Ignazio Olivieri Costantino Pitzalis Myles Lewis Rosa Daniela Grembiale Anti-TNF-alpha agents and endothelial function in rheumatoid arthritis: a systematic review and meta-analysis
description	Abstract Rheumatoid arthritis (RA) has been associated with endothelial dysfunction, a pathophysiological feature of atherosclerosis. Our aim was to determine whether TNF-α blockade has a beneficial effect on endothelial function in RA. We performed a systematic review with meta-analysis to evaluate the effect of anti-TNF-α agents on endothelial function in RA patients. MedLine, Cochrane CENTRAL and SCOPUS were searched up to March 2016. Inclusion criteria were: 1) randomised controlled trial (RCT), quasi-RCT, before-after cohort study; 2) including RA patients; 3) treatment with anti-TNF-α medications; 4) evaluating the change from baseline in endothelial function. The search strategy retrieved 180 records, of which 20 studies were included in the systematic review. Pooled analysis using a random-effects model demonstrated a significant improvement in endothelial function following anti-TNF-α treatment (SDM 0.987, 95%CI [0.64–1.33], p < 0.0001). Generalisation of the results of the meta-analysis may be limited due to the presence of heterogeneity (I2 = 82.65%, p < 0.001) and evidence of possible publication bias. Meta-regression showed that endothelial function measurement technique was a significant contributor to heterogeneity. In conclusion, although limited by the methodological quality of the included studies, our meta-analysis suggests that anti-TNF-α treatment may improve endothelial function in RA patients.
format	article
author	Francesco Ursini Christian Leporini Fabiola Bene Salvatore D’Angelo Daniele Mauro Emilio Russo Giovambattista De Sarro Ignazio Olivieri Costantino Pitzalis Myles Lewis Rosa Daniela Grembiale
author_facet	Francesco Ursini Christian Leporini Fabiola Bene Salvatore D’Angelo Daniele Mauro Emilio Russo Giovambattista De Sarro Ignazio Olivieri Costantino Pitzalis Myles Lewis Rosa Daniela Grembiale
author_sort	Francesco Ursini
title	Anti-TNF-alpha agents and endothelial function in rheumatoid arthritis: a systematic review and meta-analysis
title_short	Anti-TNF-alpha agents and endothelial function in rheumatoid arthritis: a systematic review and meta-analysis
title_full	Anti-TNF-alpha agents and endothelial function in rheumatoid arthritis: a systematic review and meta-analysis
title_fullStr	Anti-TNF-alpha agents and endothelial function in rheumatoid arthritis: a systematic review and meta-analysis
title_full_unstemmed	Anti-TNF-alpha agents and endothelial function in rheumatoid arthritis: a systematic review and meta-analysis
title_sort	anti-tnf-alpha agents and endothelial function in rheumatoid arthritis: a systematic review and meta-analysis
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/10c5a376fa1a4585b4253aeec2845f48
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Anti-TNF-alpha agents and endothelial function in rheumatoid arthritis: a systematic review and meta-analysis

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