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The Safety and Efficacy of Etanercept on Cardiac Functions and Lipid Profile in Patients With Active Rheumatoid Arthritis
  1. Soner Senel, MD*†,
  2. Veli Cobankara, MD,
  3. Ozgur Taskoylu, MD,
  4. Ugur Karasu, MD,
  5. Hekim Karapinar, MD§,
  6. Eda Erdis, MD,
  7. Harun Evrengul, MD,
  8. Mehmet Gungor Kaya, MD
  1. From the *Division of Rheumatology, Cumhuriyet University School of Medicine, Sivas; Divisions of †Rheumatology and ‡Cardiology, Pamukkale University School of Medicine, Denizli; Divisions of §Cardiology and ∥Radiation Oncology, Cumhuriyet University School of Medicine, Sivas; and ¶Division of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey.
  1. Received July 21, 2011, and in revised form September 21, 2011.
  2. Accepted for publication September 27, 2011.
  3. Reprints: Soner Senel, MD, Department of Rheumatology, Cumhuriyet University School of Medicine, 58140 Sivas, Turkey. E-mail: drsonersenel{at}


Objectives Patients with rheumatoid arthritis (RA) are known to be at increased cardiovascular risk. Etanercept is a tumor necrosis factor α (TNF-α) blocking agent that has been successfully used in the treatment of RA. We sought to assess the effects of etanercept on cardiac functions and lipid profile in RA patients without overt cardiac disease.

Methods Sixteen patients with active RA were recruited to the study prospectively. Etanercept was administered subcutaneously twice a week for 6 months. Clinical and laboratory predictors of RA activity and lipid profile were evaluated at baseline and at 6 months. The systolic and diastolic function parameters of the left ventricle were obtained by echocardiographic examination and included mitral inflow Doppler and tissue Doppler imaging.

Results Sixteen patients (13 women; median age, 48 years [range, 27–69 years]) completed the study. Patients’ 28-item Disease Activity Score and Health Assessment Questionnaire scores were significantly reduced by treatment (6.35 to 4.45 [P < 0.001] and 2.0 to 0.75 [P = 0.005], respectively). Diastolic dysfunction was detected in 6 patients (37.5%) (3 in grade 1 and 3 in grade 2) by mitral inflow Doppler and the tissue Doppler parameters before the treatment. No significant change in diastolic dysfunction was observed during follow-up (6/16 to 5/16, P = 0.164). In addition, there were also no significant differences in the left ventricular ejection fraction (65.8–66.9, P = 0.168) and lipid profiles after 6 months of etanercept treatment.

Conclusions Etanercept treatment was safe for use as regards cardiac functions and lipid profiles and effective on RA parameters during 6-month follow-up in patients with active RA.

Key Words
  • rheumatoid arthritis
  • etanercept
  • lipid profile
  • cardiac function
  • echocardiography

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