Show simple item record

dc.contributor.authorNguyen, Thao
dc.contributor.authorHokstad, Ingrid
dc.contributor.authorFagerland, Morten
dc.contributor.authorMollnes, Tom Eirik
dc.contributor.authorHollan, Ivana
dc.contributor.authorFeinberg, Mark W.
dc.contributor.authorHjeltnes, Gunnbjørg
dc.contributor.authorEilertsen, Gro Østli
dc.contributor.authorMikkelsen, Knut
dc.contributor.authorAgewall, Stefan
dc.date.accessioned2022-08-23T08:55:31Z
dc.date.available2022-08-23T08:55:31Z
dc.date.issued2022-02-25
dc.description.abstractBackground The complement system plays an important role in pathophysiology of cardiovascular disease (CVD), and might be involved in accelerated atherogenesis in rheumatoid arthritis (RA). The role of complement activation in response to treatment, and in development of premature CVD in RA, is limited. Therefore, we examined the effects of methotrexate (MTX) and tumor necrosis factor inhibitors (TNFi) on complement activation using soluble terminal complement complex (TCC) levels in RA; and assessed associations between TCC and inflammatory and cardiovascular biomarkers. Methods We assessed 64 RA patients starting with MTX monotherapy (n = 34) or TNFi with or without MTX co-medication (TNFi±MTX, n = 30). ELISA was used to measure TCC in EDTA plasma. The patients were examined at baseline, after 6 weeks and 6 months of treatment. Results Median TCC was 1.10 CAU/mL, and 57 (89%) patients had TCC above the estimated upper reference limit (<0.70). Compared to baseline, TCC levels were significantly lower at 6-week visit (0.85 CAU/mL, p<0.0001), without significant differences between the two treatment regimens. Notably, sustained reduction in TCC was only achieved after 6 months on TNFi±MTX (0.80 CAU/mL, p = 0.006). Reductions in TCC after treatment were related to decreased C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and interleukin 6, and increased levels of total, high and low-density lipoprotein cholesterol. Similarly, baseline TCC was significantly related to baseline CRP, ESR and interleukin 6. Patients with endothelial dysfunction had higher baseline TCC than those without (median 1.4 versus 1.0 CAU/mL, p = 0.023). Conclusions Patients with active RA had elevated TCC, indicating increased complement activation. TCC decreased with antirheumatic treatment already after 6 weeks. However, only treatment with TNFi±MTX led to sustained reduction in TCC during the 6-month follow-up period. RA patients with endothelial dysfunction had higher baseline TCC compared to those without, possibly reflecting involvement of complement in the atherosclerotic process in RA.en_US
dc.identifier.citationNguyen T, Hokstad I, Fagerland M, Mollnes TE, Hollan I, Feinberg MW, Hjeltnes G, Eilertsen G Ø, Mikkelsen K, Agewall S. Antirheumatic therapy is associated with reduced complement activation in rheumatoid arthritis. PLOS ONE. 2022;17(2): e0264628:1-18en_US
dc.identifier.cristinIDFRIDAID 2007952
dc.identifier.doi10.1371/journal.pone.0264628
dc.identifier.issn1932-6203
dc.identifier.urihttps://hdl.handle.net/10037/26348
dc.language.isoengen_US
dc.publisherPublic Library of Scienceen_US
dc.relation.journalPLOS ONE
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2022 The Author(s)en_US
dc.titleAntirheumatic therapy is associated with reduced complement activation in rheumatoid arthritisen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


File(s) in this item

Thumbnail

This item appears in the following collection(s)

Show simple item record