Effect of Tumor Necrosis Factor Alpha Inhibitor and Interleukin-6 Inhibitor Therapy on Endothelial Dysfunction in Patients with Rheumatoid Arthritis
https://doi.org/10.24884/1682-6655-2025-24-3-13-25
Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by damage to joints and internal organs. The introduction of biologic disease-modifying antirheumatic drugs (bDMARDs) into clinical practice has significantly improved the quality of life of patients with RA, reduced the incidence of disabling changes in the joints, and provided good control over disease activity. At the same time, the problem of accelerated atherosclerosis and increased cardiovascular risk in RA remains relevant. Endothelial dysfunction (ED) and systemic inflammation make a significant contribution to the progression of atherosclerosis in patients with RA. This review analyzes the role of interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-a) in the pathogenesis of atherosclerosis and ED, presents current scientific data on the effect of bDMARDs on endothelial function in patients with RA, and also considers laboratory markers and instrumental methods for studying ED. Programmed cell death protein 1 (PD-1), IL-18, IL-10, granulocyte-macrophage colony-stimulating factor (GM-CSF), and fractalin are promising therapeutic targets in the treatment of RA and atherosclerosis. When planning and organizing clinical trials of new drugs intended for the treatment of RA, it is justified to include additional endpoints devoted to assessing the development and progression of atherosclerosis and ED. According to experimental and clinical studies, therapy with bDMARDs helps to reduce the severity of ED, which has a positive effect on the condition of the vascular wall, slows the progression of atherosclerotic lesions of the arteries and reduces cardiovascular mortality in patients with RA. In this regard, it is appropriate to consider the possible inclusion of atherosclerosis in the indications for initiating therapy with bDMARDs in patients with RA.
About the Author
A. A. Kononykhin
Ilizarov National Medical Research Center for Traumatology and Orthopedics
Russian Federation
Russian Federation
Kononykhin Aleksey A. – Postgraduate Student
6, Maria Ulyanova street, Kurgan, 640014
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Kononykhin A.A. Effect of Tumor Necrosis Factor Alpha Inhibitor and Interleukin-6 Inhibitor Therapy on Endothelial Dysfunction in Patients with Rheumatoid Arthritis. Regional blood circulation and microcirculation. 2025;24(3):13-25. (In Russ.) https://doi.org/10.24884/1682-6655-2025-24-3-13-25
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