PMID- 22045840
OWN - NLM
STAT- MEDLINE
DCOM- 20120501
LR  - 20151119
IS  - 1499-2752 (Electronic)
IS  - 0315-162X (Linking)
VI  - 39
IP  - 1
DP  - 2012 Jan
TI  - Biological drug treatment of rheumatoid arthritis and spondyloarthritis: effects 
      on QT interval and QT dispersion.
PG  - 41-5
LID - 10.3899/jrheum.110158 [doi]
AB  - OBJECTIVE: Tumor necrosis factor-alpha (TNF-alpha) antagonists bring about significant 
      improvement in chronic inflammatory diseases such as rheumatoid arthritis (RA) 
      and spondyloarthritis (SpA). There is some evidence that they can also have 
      negative myocardial effects, but to date this issue has not been clarified. We 
      evaluated changes in electrocardiographic measures [QT interval, corrected, 
      dispersion, and dispersion corrected (QT, QTc, QTd, QTdc, respectively)] in 
      patients with RA or SpA treated with anti-TNF agents (infliximab and etanercept), 
      those treated with other biological agents (rituximab), and with methotrexate. 
      METHODS: We studied 38 consecutive patients with RA (21 patients) or SpA (19 
      patients) being treated with TNF-alpha antagonists, 8 patients with RA being treated 
      with rituximab, and 13 patients (8 with RA and 5 with SpA) taking methotrexate. 
      Electrocardiographs (ECG) were performed on all participants at baseline and 12 
      months after initiation of treatment, and the QT, QTc, and QTd were calculated 
      with standard procedures. RESULTS: After 12 months of treatment, significant 
      increases over baseline values were observed in the mean QT (p < 0.009), QTd (p < 
      0.0001), and QTdc (p < 0.0001) of the anti-TNF group, but no significant changes 
      were observed in those taking rituximab. QT changes in the anti-TNF group were 
      unrelated to the disease (RA vs SpA) or drug (infliximab vs etanercept), and none 
      were associated with clinical manifestations of cardiac disease. CONCLUSION: In 
      patients with RA and SpA, TNF-alpha antagonists seem to increase the QT and QTd 
      measures. Although these changes were completely asymptomatic, ECG may be 
      indicated in patients being considered for anti-TNF therapy to identify those at 
      risk for cardiac complications.
FAU - DI Franco, Manuela
AU  - DI Franco M
AD  - Cattedra di Reumatologia, Dipartimento di Medicina Interna e Specialita Mediche, 
      Sapienza Universita di Roma, Viale del Policlinico 155, 00161 Rome, Italy. 
      manuela.difranco@uniroma1.it
FAU - Paradiso, Michele
AU  - Paradiso M
FAU - Ceccarelli, Fulvia
AU  - Ceccarelli F
FAU - Scrivo, Rossana
AU  - Scrivo R
FAU - Spinelli, Francesca Romana
AU  - Spinelli FR
FAU - Iannuccelli, Cristina
AU  - Iannuccelli C
FAU - Valesini, Guido
AU  - Valesini G
LA  - eng
PT  - Journal Article
DEP - 20111101
PL  - Canada
TA  - J Rheumatol
JT  - The Journal of rheumatology
JID - 7501984
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Murine-Derived)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Immunoglobulin G)
RN  - 0 (Receptors, Tumor Necrosis Factor)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 4F4X42SYQ6 (Rituximab)
RN  - B72HH48FLU (Infliximab)
RN  - OP401G7OJC (Etanercept)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
MH  - Antibodies, Monoclonal/pharmacology/therapeutic use
MH  - Antibodies, Monoclonal, Murine-Derived/pharmacology/therapeutic use
MH  - Antirheumatic Agents/*pharmacology/*therapeutic use
MH  - Arthritis, Rheumatoid/*drug therapy/*physiopathology
MH  - Electrocardiography
MH  - Etanercept
MH  - Humans
MH  - Immunoglobulin G/pharmacology/therapeutic use
MH  - Infliximab
MH  - Methotrexate/pharmacology/therapeutic use
MH  - Myocardial Contraction/*drug effects
MH  - Receptors, Tumor Necrosis Factor/therapeutic use
MH  - Retrospective Studies
MH  - Rituximab
MH  - Spondylarthritis/*drug therapy/*physiopathology
MH  - Tumor Necrosis Factor-alpha/antagonists & inhibitors
EDAT- 2011/11/03 06:00
MHDA- 2012/05/02 06:00
CRDT- 2011/11/03 06:00
PHST- 2011/11/03 06:00 [entrez]
PHST- 2011/11/03 06:00 [pubmed]
PHST- 2012/05/02 06:00 [medline]
AID - jrheum.110158 [pii]
AID - 10.3899/jrheum.110158 [doi]
PST - ppublish
SO  - J Rheumatol. 2012 Jan;39(1):41-5. doi: 10.3899/jrheum.110158. Epub 2011 Nov 1.