NT-proBNP and sRAGE levels in early rheumatoid arthritis

Abstract

Objective

Several biomarkers of cardiovascular function are found to be increased in rheumatoid arthritis (RA), with some suggesting a relationship with disease activity and improvement with adequate anti-rheumatic treatment. Promising biomarkers include N-terminal pro-brain natriuretic peptide (NT-proBNP) and the soluble receptor form of advanced glycation end-products (sRAGE). The objective of this study was to investigate associations between NT-proBNP and sRAGE levels and markers of inflammation and disease activity in early RA patients and their changes during (effective) anti-rheumatic treatment.

Method

Data from 342 consecutive early RA patients participating in the ‘Parelsnoer’ cohort were used. At baseline and after 6 months’ disease activity, NT-proBNP and sRAGE levels were assessed.

Results

After 6 months, NT-proBNP decreased from 83 pmol/L (mean) at baseline to 69 pmol/L at follow-up (p < 0.001), while sRAGE increased from 997 pg/mL to 1125 pg/mL (p < 0.001). A larger decrease in erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) was associated with larger changes in NT-proBNP and sRAGE. For every point decrease in ESR, there was a 1.7-point decrease in NT-proBNP and a 2.2-point increase in sRAGE. For CRP, these values were 1.7 and 2.7, respectively (p < 0.001).

Conclusion

Suppressing inflammation, independently of achieving remission, increases sRAGE levels and decreases NT-proBNP levels significantly. Whether this translates into a decrease in incident cardiovascular disease remains to be elucidated.

Acknowledgements

The authors would like to acknowledge the employees from our biobank, Toni de Jong-de Boer and Corrie Verdoold, the Parelsnoer data managers Jozé Krol-van Berkel and Judith Mannien, and Professor Twisk for his assistance with the statistical aspects of this manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Author contributions

Study design: MH, RA, DW, TH, JL, AB, WL, and MN; data collection: TH, JL, AB, WL, and MN; Data analysis: MH, RA, MN; interpretation of findings: MH, CT, RA, DW, TH, JL, AB, WL, and MN; preparation of manuscript: MH, CT, RA, DW, TH, JL, AB, WL, and MN. All authors read and approved the final manuscript.

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. https://www.health-ri.nl/uitgifteproces-klinische-biobank

Supplemental material

Supplemental data for this article can be accessed https://doi.org/10.1080/03009742.2022.2042975.