Secukinumab effect on the myocardial dysfunction development in patients with ankylosing spondylitis

L.I. Feiskhanova, S.A. Lapshina

Kazan State Medical University, Kazan

Background: in ankylosing spondylitis (AS), early subclinical changes in the myocardium mostly remain undiagnosed. The impact of genetic engineering biological therapy (GEBT) on these changes is also unclear.

Aim: to establish the association between the secukinumab intake and changes in systolic and diastolic functions of myocardium in patients with AS.

Patients and Methods: 69 patients with confirmed AS were examined: the first group included 33 patients (average age 38.8±4.74, 63.6% of men) who received the interleukin 17 (IL-17) inhibitor — secukinumab, the second group — 36 patients who did not receive GEBT (average age 42.5±11 years, 66.7% of men). The control group included 40 healthy subjects, comparable in gender and age. Patients underwent tissue doppler echocardiography, transthoracic echocardiogram, and determination of matrix metalloproteinase-9 (MMP-9) level in blood serum. Statistical processing  of results was performed using STATISTICA 10.0 software.

Results: there was significantly (p<0.01) higher left ventricular mass index and ejection fraction in patients with AS compared to the control group, although they were generally within normal range. Moreover, the indicators were the highest among patients who did not receive GEBT, diastolic dysfunction was diagnosed only in this group (in 38.9%). In the setting of the secukinumab therapy, there was an increase in the systolic function of the myocardium. Analysis of the MMP-9 level in the blood serum of patients with AS showed significant (p<0.001) differences with the control group. In the group of patients receiving secukinumab, the elevation of MMP-9 level was associated with a deterioration of right ventricular systolic function and left ventricular diastolic function.

Conclusion: AS is characterized by a high frequency of subclinical cardiovascular disease. Inhibition of IL-17 can reduce diastolic dysfunction, which is confirmed by an improvement in myocardial contrac tility during secukinumab therapy.

Keywords: ankylosing spondylitis, spondylarthritis, diastolic dysfunction, myocardial contractility, secukinumab, interleukin 17 inhibitor, matrix metalloproteinase, tissue doppler echocardiography.

For citation: Feiskhanova L.I., Lapshina S.A. Secukinumab effect on the myocardial dysfunction development in patients with ankylosing spondylitis. RMJ. 2020;11:49–53.