Yıl 2018, Cilt 4, Sayı 4, Sayfalar 362 - 365 2018-10-04

Changes in cerebral blood flow in rheumatology patients treated with rituximab

Uygar Utku [1] , Gözde Çetin [2] , Nurhan Atilla [3]

59 136

Objective: We aimed to assess the effects of rituximab therapy on cerebral hemodynamics  in rheumatic patients with transcranial Doppler (TCD) ultrasonography. 

Methods: The study included seven patients aged 20-65 years (2 patients with secondary interstitial lung involvement to rheumatoid arthritis, 3 patients with systemic lupus erythematosus and lupus nephritis, 2 patients with scleroderma and secondary interstitial lung disease) who received rituximab treatment due to rheumatic diseases. Healthy control group (non-rheumatic group) consisted of seven age and sex-matched, randomly selected persons did not have risk factors for atherosclerosis. Bilateral middle cerebral artery peak-systolic, end-diastolic, and mean blood flow velocities, Gosling’s pulsatility index values, and Pourcelot’s resistance index values were recorded with TCD by a neurosonologist before rituximab administration. Control TCD performed to the rheumatic group after six months from the last rituximab dosage. 

Results: One patient was male and six patients were female. Peak-systolic, end-diastolic and mean blood flow velocities of rheumatic patients were significantly higher than healthy group (p < 0.001). Peak-systolic, end-diastolic and mean blood flow velocities of rheumatic patients were significantly decreased after rituximab therapy (p < 0.001).

Conclusions: This study highlights that the increased cerebral blood flow is indirectly associated with atherosclerosis regarding persistent inflammation in patients with rheumatic diseases. It was thought that treatment with rituximab could reverse this situation. 

Rituximab, inflammation, atherosclerosis, cerebral blood flow
  • [1] Ross R. Atherosclerosis -- an inflammatory disease. N Engl J Med 1999;340:115-26.
  • [2] Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation 2002;105:1135-43.
  • [3] Selmi C, Generali E, Massarotti M, Bianchi G, Sciré CA. New treatments for inflammatory rheumatic disease. Immunol Res 2014;60:277-88.
  • [4] Yüksel S, Ayvazyan L, Gasparyan AY. Familial mediterranean fever as an emerging clinical model of atherogenesis associated with low-grade inflammation. Open Cardiovasc Med J 2010;23:4:51-6.
  • [5] Lin CW, Huang YP, Chiu YH, Ho YT, Pan SL. Increased risk of ischemic stroke in young patients with ankylosing spondylitis: a population-based longitudinal follow-up study. PloS One 2014;9:e94027.
  • [6] Kerekes G, Soltesz P, Der H, Veres K, Szabo Z, Vegvari A, et al. Effects of biologics on vascular function and atherosclerosis associated with rheumatoid arthritis. Ann N Y Acad Sci 2009;1173:814-21.
  • [7] Szekanecz Z, Kerekes G, Soltesz P. Vascular effects of biologic agents in RA and spondyloarthropathies. Nat Rev Rheumatol 2009;5:677-84.
  • [8] Provan SA, Berg IJ, Hammer HB, Mathiessen A, Kvien TK, Semb AG. The impact of newer biological disease modifying anti-rheumatic drugs on cardiovascular risk factors: a 12-month longitudinal study in rheumatoid arthritis patients treated with rituximab, abatacept and tociliziumab. PloS One 2015;10:e0130709.
  • [9] Mathieu S, Pereira B, Dubost JJ, Lusson JR, Soubrier M. No significant changes in arterial stiffness in RA after 6 months and 1 year of rituximab treatment. Rheumatology (Oxford) 2012;51:1107-11.
  • [10] de Riva N., Budohoski KP, Smielewski P, Kasprowicz M, Zweifel C, Steiner LA, et al. Transcranial Doppler pulsatility index: what it is and what it isn’t. Neurocrit Care 2012;17:58-66.
  • [11] Bos MJ, Koudstaal PJ, Hofman A, Witteman JC, Breteler MM. Transcranial Doppler hemodynamic parameters and risk of stroke: the Rotterdam study. Stroke 2007;38:2453-8.
Birincil Dil en
Konular Sağlık Bilimleri
Dergi Bölümü Original Article
Yazarlar

Orcid: 0000-0003-1280-4754
Yazar: Uygar Utku
Kurum: Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Neurology, Kahramanmaras
Ülke: Turkey


Orcid: 0000-0001-9680-7535
Yazar: Gözde Çetin
Kurum: Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Rheumatology
Ülke: Turkey


Orcid: 0000-0003-4127-4924
Yazar: Nurhan Atilla
Kurum: Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Pulmonology, Kahramanmaras
Ülke: Turkey


Bibtex @araştırma makalesi { eurj346321, journal = {The European Research Journal}, issn = {}, eissn = {2149-3189}, address = {Sağlık Araştırmaları ve Stratejileri Derneği}, year = {2018}, volume = {4}, pages = {362 - 365}, doi = {10.18621/eurj.346321}, title = {Changes in cerebral blood flow in rheumatology patients treated with rituximab}, key = {cite}, author = {Utku, Uygar and Atilla, Nurhan and Çetin, Gözde} }
APA Utku, U , Çetin, G , Atilla, N . (2018). Changes in cerebral blood flow in rheumatology patients treated with rituximab. The European Research Journal, 4 (4), 362-365. DOI: 10.18621/eurj.346321
MLA Utku, U , Çetin, G , Atilla, N . "Changes in cerebral blood flow in rheumatology patients treated with rituximab". The European Research Journal 4 (2018): 362-365 <http://dergipark.gov.tr/eurj/issue/32988/346321>
Chicago Utku, U , Çetin, G , Atilla, N . "Changes in cerebral blood flow in rheumatology patients treated with rituximab". The European Research Journal 4 (2018): 362-365
RIS TY - JOUR T1 - Changes in cerebral blood flow in rheumatology patients treated with rituximab AU - Uygar Utku , Gözde Çetin , Nurhan Atilla Y1 - 2018 PY - 2018 N1 - doi: 10.18621/eurj.346321 DO - 10.18621/eurj.346321 T2 - The European Research Journal JF - Journal JO - JOR SP - 362 EP - 365 VL - 4 IS - 4 SN - -2149-3189 M3 - doi: 10.18621/eurj.346321 UR - http://dx.doi.org/10.18621/eurj.346321 Y2 - 2018 ER -
EndNote %0 The European Research Journal Changes in cerebral blood flow in rheumatology patients treated with rituximab %A Uygar Utku , Gözde Çetin , Nurhan Atilla %T Changes in cerebral blood flow in rheumatology patients treated with rituximab %D 2018 %J The European Research Journal %P -2149-3189 %V 4 %N 4 %R doi: 10.18621/eurj.346321 %U 10.18621/eurj.346321
ISNAD Utku, Uygar , Çetin, Gözde , Atilla, Nurhan . "Changes in cerebral blood flow in rheumatology patients treated with rituximab". The European Research Journal 4 / 4 (Ekim 2018): 362-365. http://dx.doi.org/10.18621/eurj.346321