Ambrosino, Pasquale (2020) Changes in endothelial function in patients with psoriatic arthritis treated with apremilast. A 1-year prospective cohort study. [Tesi di dottorato]

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Tipologia del documento: Tesi di dottorato
Lingua: English
Titolo: Changes in endothelial function in patients with psoriatic arthritis treated with apremilast. A 1-year prospective cohort study.
Autori:
AutoreEmail
Ambrosino, Pasqualepasquale.ambrosino@live.com
Data: 12 Marzo 2020
Numero di pagine: 32
Istituzione: Università degli Studi di Napoli Federico II
Dipartimento: Medicina Clinica e Chirurgia
Dottorato: Terapie avanzate medico-chirurgiche
Ciclo di dottorato: 32
Coordinatore del Corso di dottorato:
nomeemail
Di Minno, Giovannigiovanni.diminno@unina.it
Tutor:
nomeemail
Di Minno, Giovanni[non definito]
Data: 12 Marzo 2020
Numero di pagine: 32
Parole chiave: psoriatic arthritis, cardiovascular risk.
Settori scientifico-disciplinari del MIUR: Area 06 - Scienze mediche > MED/09 - Medicina interna
Depositato il: 22 Mar 2020 10:25
Ultima modifica: 10 Nov 2021 10:01
URI: http://www.fedoa.unina.it/id/eprint/13066

Abstract

Background. Psoriatic arthritis (PsA) is one of the most common chronic inflammatory diseases worldwide, and cardiovascular (CV) disease is a leading cause of morbidity and mortality in this clinical setting. Aims. To evaluate changes in vascular reactivity in patients with PsA during 12-month treatment with an oral phosphodiesterase-4 inhibitor, apremilast. Methods. Patients with PsA starting a treatment with apremilast were included. Brachial artery flow-mediated dilation (FMD) with reactive hyperemia index (RHI) were evaluated at study entry (T0), after 3 months (T3m), 6 months (T6m) and 12 months (T12m) of treatment with apremilast. Measures of disease activity and function were also evaluated at each time-point. Results. Twenty-three subjects were enrolled (26.1% males, mean age 60.9 ± 8.6 years). At baseline assessment, the FMD was 4.19% ± 2.35 and RHI 2.60 ± 0.59. During the overall study period, we found a progressive and significant improvement of FMD values at each time-point, with an overall 90.4% median increase from T0 to T12m (from 4.19% ± 2.35 to 8.20% ± 2.30, P<0.001), accompanied by a 24.2% median increase in RHI values (from 2.60 ± 0.59 to 3.33 ± 0.99, P=0.007). As compared to T0 values, apremilast also determined a progressive and consistent improvement of clinical measures of disease activity and function, with a 56.6% median reduction in Disease Activity Index for Psoriatic Arthritis (DAPSA) score, a 28.7% median reduction in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score, and a 33.3% median reduction in Bath Ankylosing Spondylitis Functional Index (BASFI) score at T12m (P always <0.05). Overtime values of FMD showed an inverse correlation with DAPSA (rho=-0.504, P<0.001), BASDAI (rho=-0.453, P<0.001), and BASFI (rho=-0.386, P=0.001). Conclusions. Apremilast is able to progressively and significantly improve vascular reactivity during 12 months of treatment. These changes are correlated to changes in clinical measures of disease activity and function in patients with PsA.

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