Volume 28, Issue 6 (9-2021)                   RJMS 2021, 28(6): 0-0 | Back to browse issues page

Research code: Not applicable
Ethics code: IR.IUMS.FMD.REC.1396.93112880044
Clinical trials code: Not applicable

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Fazaeli A, Javadzadeh A, Shirani F. The effect of treatment with TNF-α inhibitors on the components of metabolic syndrome and also the severity of disease in patients with psoriatic arthritis. RJMS. 2021; 28 (6)
URL: http://rjms.iums.ac.ir/article-1-6876-en.html
, shiranifa@gmail.com
Abstract:   (222 Views)
Background: Psoriasis is a chronic inflammatory disease that is associated with a major impairment in the quality of life of patients in the mild stages of the disease and extensive cardiovascular and metabolic disorders that lead to the death of the patient in the severe form of the disease. It is important to consider the systemic nature of psoriasis because patient data suggest that patients with more severe manifestations of the disease have a 50% increased risk of death, which would result in a 5-year reduction in their life expectancy. Regarding the role of inflammatory processes, especially TNF-ɑ, in increasing the incidence of metabolic syndrome and the severity of inflammatory symptoms of rheumatologic diseases, it seems that the presence of drugs such as anti- TNF-ɑ drugs may play a role in reducing arthritic symptoms and improving the complexity of the metabolic syndrome. The aim of this study is to determine the effect of using anti- TNF-ɑ drugs on relieving symptoms of arthritis and modifying components of the metabolic syndrome in addition to determining the metabolic syndrome prevalence in patients with psoriatic arthritis.
Methods: The type of study in the first phase was a cross-sectional study and in the second phase was a retrospective before-after intervention study. The study population included all patients admitted or referred to Rasoul Akram Hospital with a diagnosis of psoriatic arthritis during 2006 and 2016. By reviewing the records of 90 patients, the severity of the disease (including PASI score) and the definitive components of the metabolic syndrome (based on ITP-III criteria), were collected at the time of admission (before taking any medication) and recorded in the checklist. Then, based on the definition of metabolic syndrome, the prevalence of the syndrome was determined. Patients who were treated with α-TNF-inhibitors (such as infliximab or etanercept) for at least 24 weeks were evaluated. Again, by referring to the patientschr(chr('39')39chr('39')) records, the severity of the disease as well as the defining components of the metabolic syndrome were extracted in the patients treated with α-TNF inhibitors at both the time before and after the completion of the treatment period. The results were expressed as mean and quantitative standard deviation (± SD) for quantitative variables and as a percentage for stratified qualitative variables. T-test was used to compare quantitative variables and chi-square test was used to compare qualitative variables. P-value less than 0.05 was considered significant. SPSS software version 22 was used for statistical analysis of data.
Results: In terms of metabolic syndrome based on ATP-III definitions, a total of 20 (22.2%) patients had metabolic syndrome. The prevalence of metabolic syndrome was independent of gender, age, and type of α-TNF inhibitor, but had a significant relationship with the duration of arthritis. Following treatment with TNF-alpha inhibitors, there was a significant improvement in metabolic syndrome components including BMI, fasting blood glucose, triglyceride, cholesterol, LDL, and ESR. In the severity of arthritis involvement (based on the PASI score and number of joints involved), significant improvement was observed in the two above-mentioned indicators after treatment with TNF-ɑ inhibitors.
Conclusion: In this study, and in line with previous studies, with the aim of evaluating the effects of TNF-ɑ inhibitors on improving both the clinical manifestations of arthritis and the improvement of metabolic syndrome and its components, Involvement was accompanied by psoriatic arthritis (based on the number of joints involved as well as the PASI score). The prevalence of metabolic syndrome in patients with psoriatic arthritis in Iran is estimated at 22.2%. Secondly, the use of TNF-ɑ antagonist drugs results in an improvement in both the clinical manifestations of arthritis and significant improvement in metabolic syndrome and its components in these patients.
Type of Study: Research | Subject: Rheumatology

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