Incidence of new carotid plaques in rheumatoid arthritis patients: 6-Year prospective results of the TOMORROW study

• Published in: Modern rheumatology 2023-04, Vol.33 (3), p.481-489
• Main Authors: Anno, Shohei, Okano, Tadashi, Mamoto, Kenji, Sugioka, Yuko, Tada, Masahiro, Inui, Kentaro, Koike, Tatsuya, Nakamura, Hiroaki
• Format: Article
• Language: English
• Subjects: Arthritis, Rheumatoid - complications; Arthritis, Rheumatoid - diagnostic imaging; Arthritis, Rheumatoid - epidemiology; Carotid Arteries - diagnostic imaging; Carotid Artery Diseases - complications; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - epidemiology; Glucocorticoids; Humans; Incidence; Plaque, Atherosclerotic - complications; Plaque, Atherosclerotic - diagnostic imaging; Prospective Studies; Risk Factors
• ISSN: 1439-7595; 1439-7609
• DOI: 10.1093/mr/roac051

ABSTRACT Objectives The purpose of this study was to evaluate the new incidence of carotid plaques in rheumatoid arthritis (RA) patients over a 6-year prospective follow-up and to assess the risk factors. Methods This is a 10-year prospective cohort study that included 208 RA patients and 205 age- and gender-matched controls. Ultrasound assessment of the bilateral carotid arteries was performed in 2011 and 2017. Results There were no differences in the incidence of new carotid atherosclerotic plaques over 6 years between the two groups (35.5% vs. 37.0%, respectively; p = .936). The mean Disease Activity Score 28-C-reactive protein over 6 years in RA patients was 2.73 ± 0.95. Multiple logistic regression analysis showed that RA was not a risk factor for new carotid atherosclerotic plaques (odds ratios, 0.708; 95% confidence interval, 0.348–1.440; p = .340). An average glucocorticoid dose of >1.8 mg/day over 6 years was a risk factor for new carotid atherosclerotic plaques (odds ratios, 8.54; 95% confidence interval, 1.641–44.455; p = .011). Conclusions Incidence of new carotid atherosclerotic plaques was similar between well-controlled disease activity RA patients and control subjects. A mean glucocorticoid dose of >1.8 mg/day over 6 years was a risk factor for new carotid atherosclerotic plaques.