Table 2.
Changes in disease activity markers, oxidative stress markers, endothelial glycocalyx thickness, vascular markers and echocardiographic markers of LV myocardial function in the study population during the study period.
| Tocilizumab (n = 40) |
csDMARDs + GC (n = 40) |
P-value | Controls (n = 40) |
|||
|---|---|---|---|---|---|---|
| Baseline | 3 months | Baseline | 3 months | Baseline | ||
| DAS28 | 6.1 (5.2–6.8) | 3.7 (3.4–4.3) | 5.6 (3.8–7) | 4.1 (3.1–5.1) | 0.241 | – |
| CRP, mg/L | 13.7 (7.2–40) | 2.3 (0.1–5.5) | 11.6 (6.5–36.2) | 5.9 (2.1–10.2) | 0.003 | 1.4 (0.01–2.0)*† |
| MDA, μM/L | 1.8 (1.2–2.5) | 1.0 (0.6–1.4) | 2.0 (1.8–3.2) | 1.9 (1.9–3.2) | 0.003 | 0.97 (0.84–1.30) *† |
| PCs, nmol/mg | 0.0136 (0.011–0.014) | 0.0108 (0.008–0.014) | 0.0129 (0.008–0.014) | 0.0126 (0.007–0.013) | 0.004 | 0.0093 (0.007–0.101) *† |
| PBR, 5–25 μm | 2.14 ± 0.2 | 1.97 ± 0.2 | 2.2 ± 0.2 | 2.23 ± 0.3 | 0.012 | 2.04 ± 0.2*† |
| SBP, mmHg | 130 ± 15 | 125 ± 14 | 132 ± 17 | 131 ± 16 | 0.043 | 129 ± 9 |
| DBP, mmHg | 81 ± 9 | 76 ± 9 | 82 ± 9 | 80 ± 8 | 0.047 | 80 ± 6 |
| Central SBP, mmHg | 134 ± 18 | 129 ± 16 | 135 ± 19 | 134 ± 18 | 0.038 | 131 ± 11*† |
| PWV, m/s | 11 ± 3 | 10.3 ± 2 | 11.2 ± 2 | 11.5 ± 3 | 0.028 | 9.7 ± 2*† |
| AI, % | 20 (12–26) | 9.4 (4–25) | 23 (14–32) | 21 (6–24) | 0.036 | 12.3 (1–27)*† |
| LVEF, % | 65.5 ± 12 | 65.9 ± 12.5 | 64.6 ± 16 | 64.2 ± 15 | 0.463 | 66.2 ± 9 |
| Sm, cm/s | 8.9 ± 1.6 | 9.5 ± 2.1 | 8.5 ± 1.6 | 8.4 ± 1.9 | 0.574 | 9.4 ± 1.7*† |
| Em/Am | 0.80 ± 0.4 | 0.86 ± 0.4 | 0.81 ± 0.3 | 0.85 ± 0.3 | 0.452 | 0.96 ± 0.3*† |
| E/Em | 9.7 ± 3.9 | 8.7 ± 2.7 | 9.1 ± 3.3 | 9.5 ± 4.1 | 0.160 | 7.4 ± 2.4*† |
| GLS, % | −16.1 ± 2.9 | −17.6 ± 2.5 | −16.3 ± 3.2 | −16.7 ± 2.8 | 0.031 | −22.5 ± 2.2*† |
| PWV/GLS, m/s% | −0.68 ± 0.25 | −0.58 ± 0.19 | −0.68 ± 0.22 | −0.69 ± 0.26 | 0.017 | −0.45 ± 0.13*† |
| GLSR E, 1/s | 0.91 ± 0.3 | 1 ± 0.3 | 0.95 ± 0.23 | 0.99 ± 0.26 | 0.118 | 1.2 ± 0.29*† |
| GCS, % | −17.5 ± 4.7 | −20.3 ± 4.9 | −17.6 ± 5 | −17.9 ± 5.2 | 0.031 | −24.9 ± 4.6*† |
| GCSR E, 1/s | 1.09 ± 0.4 | 1.2 ± 0.4 | 1.17 ± 0.45 | 1.19 ± 0.43 | 0.084 | 1.35 ± 0.35*† |
| GRS, % | 29.8 ± 9 | 32.3 ± 10 | 30.6 ± 10 | 31.6 ± 11 | 0.030 | 37.2 ± 9*† |
| GRSR E, 1/s | −1.91 ± 0.6 | −2.19 ± 0.9 | −2.1 ± 0.97 | −2.3 ± 0.71 | 0.349 | −2.6 ± 0.51*† |
| GWI, mmHg% | 1769 ± 466 | 2014 ± 402 | 1752 ± 476 | 1802 ± 394 | 0.039 | 1935 ± 423*† |
| GCW, mmHg% | 2073 ± 551 | 2312 ± 477 | 2014 ± 370 | 2142 ± 389 | 0.033 | 2231 ± 445*† |
| GWW, mmHg% | 126 ± 74 | 97 ± 53 | 122 ± 62 | 108 ± 72 | 0.026 | 94 ± 42*† |
| GWE, % | 92 ± 5 | 94 ± 4 | 93 ± 3 | 93 ± 4 | 0.910 | 95 ± 5*† |
Data are expressed as median values (first quartile - third quartile) or mean values ± SD. csDMARDs: conventional synthetic disease-modifying antirheumatic drugs; GC: glucocorticoids; DAS28: disease activity score in 28 joints; CRP: C-reactive protein; MDA: malondialdehyde; PCs: protein carbonyls; PBR: perfused boundary region of the sublingual arterial microvessels ranged from 5 to 25 μm; SBP: systolic blood pressure; DBP: diastolic blood pressure; PWV: pulse wave velocity; AI: augmentation index; LVEF: left ventricular ejection fraction; Sm, Em, and Am by Tissue Doppler imaging; GLS: global longitudinal strain; PWV/GLS: ventricular-arterial interaction (pulse wave velocity to global longitudinal strain ratio); GLSR E global longitudinal early diastolic strain rate; GCS: global circumferential strain; GCSR E global circumferential early diastolic strain rate; GRS: global radial strain; GLSR E global radial early diastolic strain rate; GWI: global work index; GCW: global constructive work; GWW: global wasted work; GWE: global work efficiency. P-value: P for time × treatment interaction obtained by repeated measures ANOVA. *P < 0.05 for controls versus tocilizumab at baseline; †P < 0.05 for controls versus prednisolone at baseline.