Evidence map›Paper›PMID 31335881›Full record

Observational studyPloS one2019

Tumor necrosis factor inhibitors are associated with reduced complement activation in spondylarthropathies: An observational study.

Ingrid Hokstad, Gia Deyab, Morten Wang Fagerland, Torstein Lyberg, Gunnbjørg Hjeltnes, Øystein Førre, Stefan Agewall, Tom Eirik Mollnes, Ivana Hollan

Registry-linked trialOpen access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00902005 (Endothelial Function, Inflammatory Disease Activity, and Bone and Cartilage Markers in RA and Spondyloarthritis Patients, Treated With TNFalpha-inhibitors in Combination With Methotrexate or Methotrexate or TNFalpha-inhibitors Alone - a Prospective Study), which is not on this map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
2.6field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00902005 completednot on this map

Endothelial Function, Inflammatory Disease Activity, and Bone and Cartilage Markers in RA and Spondyloarthritis Patients, Treated With TNFalpha-inhibitors in Combination With Methotrexate or Methotrexate or TNFalpha-inhibitors Alone - a Prospective Study

TypeobservationalSponsorRevmatismesykehuset ASRan2008 to 2012Enrolled145ConditionsRheumatoid Arthritis, Psoriatic Arthritis, Ankylosing Spondylitis, Endothelial Dysfunction
3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 23 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. Article
  6. Review
  7. Article
  8. Article
  9. Article
  10. Review
  11. Article
  12. Article
  13. Review
  14. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Ingrid HokstadLillehammer Hospital for Rheumatic Diseases, Lillehammer, Norway.ORCID 0000-0002-8009-4670
Gia DeyabDepartment of Medical Biochemistry, Innlandet Hospital Trust, Lillehammer, Norway.
Morten Wang FagerlandOslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway.
Torstein LybergDepartment of Medical Biochemistry, Oslo University Hospital Ullevål, Oslo, Norway.
Gunnbjørg HjeltnesDepartment of Medicine, Innlandet Hospital Trust, Lillehammer, Norway.
Øystein FørreDepartment of Rheumatology, Oslo University Hospital, University of Oslo, Oslo, Norway.
Stefan AgewallInstitute of Clinical Sciences, University of Oslo, Oslo, Norway.
Tom Eirik MollnesDepartment of Immunology, Oslo University Hospital, University of Oslo, Oslo, Norway.
Ivana HollanLillehammer Hospital for Rheumatic Diseases, Lillehammer, Norway.
Oslo University Hospital · NOInnlandet Hospital Trust · NOBrigham and Women's Hospital · USUniversity of Oslo · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe complement system is involved in pathogenesis of cardiovascular disease, and might play a role in accelerated atherogenesis in spondylarthropathies (SpA). Hence, we examined complement activation in SpA, and its relationship to antirheumatic treatment, inflammatory and cardiovascular markers.

methodsFrom PSARA, a prospective observational study, we examined 51 SpA patients (31 psoriatic arthritis (PsA), and 20 ankylosing spondylitis (AS)), starting tumor necrosis factor (TNF) inhibitor alone (n = 25), combined with methotrexate (MTX) (n = 10), or MTX monotherapy (n = 16). Complement activation was determined by the soluble terminal complement complex (sC5b-9), inflammation by erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and endothelial function by finger plethysmography (Endopat) at baseline, after 6 weeks and 6 months of treatment.

resultsSpA patients had sC5b-9 levels at (PsA) or above (AS) the upper limit of the estimated reference range. Median sC5b-9 levels decreased significantly from baseline to 6 weeks, with no significant difference between the AS and PsA group. Notably, a significant reduction in sC5b-9 was observed after administration of TNF inhibitor ± MTX, whereas no significant changes were observed in patients treated with MTX alone. Between 6 weeks and 6 months, sC5b-9 remained stable across all subgroups. Reduction in sC5b-9 was independently related to decreased ESR and CRP, and to increased high density cholesterol and total cholesterol. Reduction in sC5b-9 from baseline to 6 weeks was associated with improved EF in age and gender adjusted analyses.

conclusionTNF-inhibition, but not MTX monotherapy, led to rapid and sustained reduction of complement activation in SpA. Thus, the observed decrease in cardiovascular morbidity in patients treated with TNF-inhibitors might be partly due to its beneficial effect on complement.

trial registrationClinical Trials (NCT00902005), retrospectively registered on the 14th of May 2009.

Indexed as

AdultComplement ActivationComplement Membrane Attack ComplexFemaleHumansMaleMethotrexateMiddle AgedSpondylarthropathiesTumor Necrosis Factor InhibitorsComplement Membrane Attack ComplexMethotrexateSC5b-9 protein complexTumor Necrosis Factor Inhibitors

Identifiers

PMID31335881
PMCPMC6650069
OpenAlexW2962979028

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.