Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Oncology Letters
      • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Biomedical Reports
      • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • Information for Authors
    • Information for Reviewers
    • Information for Librarians
    • Information for Advertisers
    • Conferences
  • Language Editing
Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • For Authors
    • For Reviewers
    • For Librarians
    • For Advertisers
    • Conferences
  • Language Editing
Login Register Submit
  • This site uses cookies
  • You can change your cookie settings at any time by following the instructions in our Cookie Policy. To find out more, you may read our Privacy Policy.

    I agree
Search articles by DOI, keyword, author or affiliation
Search
Advanced Search
presentation
Experimental and Therapeutic Medicine
Join Editorial Board Propose a Special Issue
Print ISSN: 1792-0981 Online ISSN: 1792-1015
Journal Cover
January-2022 Volume 23 Issue 1

Full Size Image

Sign up for eToc alerts
Recommend to Library

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

Medicine International

An International Open Access Journal Devoted to General Medicine.

Journal Cover
January-2022 Volume 23 Issue 1

Full Size Image

Sign up for eToc alerts
Recommend to Library

  • Article
  • Citations
    • Cite This Article
    • Download Citation
    • Create Citation Alert
    • Remove Citation Alert
    • Cited By
  • Similar Articles
    • Related Articles (in Spandidos Publications)
    • Similar Articles (Google Scholar)
    • Similar Articles (PubMed)
  • Download PDF
  • Download XML
  • View XML
Article

Influence of anti‑TNF therapy and homocysteine level on carotid intima‑media thickness in rheumatoid arthritis patients

  • Authors:
    • Daniela Anghel
    • Carmen Adella Sîrbu
    • Elena-Mădălina Hoinoiu
    • Oana-Georgiana Petrache
    • Cristina-Florentina Pleșa
    • Maria Magdalena Negru
    • Florentina Ioniţă‑Radu
  • View Affiliations / Copyright

    Affiliations: Department of Internal Medicine, Central Military Emergency University Hospital, 010242 Bucharest, Romania, Department of Medico‑Surgical and Prophylactic Disciplines, Faculty of Medicine, ‘Titu Maiorescu’ University, 031593 Bucharest, Romania, Department of Neurology, Central Military Emergency University Hospital, 010242 Bucharest, Romania, Department of Internal Medicine and Rheumatology, ‘Sf. Maria’ Clinical Hospital, 011172 Bucharest, Romania, Department of Internal Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020022 Bucharest, Romania
  • Article Number: 59
    |
    Published online on: November 18, 2021
       https://doi.org/10.3892/etm.2021.10981
  • Expand metrics +
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Cited By (CrossRef): 0 citations Loading Articles...

This article is mentioned in:



Abstract

It is a well-known fact that disruptions in the immune system and systemic inflammation are associated with accelerated atherosclerosis in rheumatoid arthritis (RA) patients. Elevated levels of tumor necrosis factor α (TNF‑α), a major pro‑inflammatory cytokine, are involved in endothelial cell activation of medium and large arteries, leading to increased endothelial permeability, generation of superoxide anion radical and hydrogen peroxide, and decreased availability of nitric oxide (NO). The present study aims to determine the influence of anti‑TNF therapy and homocysteine (Hcy) levels on the carotid intima‑media thickness (IMT) in patients with RA. Assessments were performed on 115 patients diagnosed with RA on biological treatment to determine the evolution of IMT and Hcy levels. Carotid ultrasonography was used to assess the IMT, as a fast and easy tool for the prediction of cardiovascular events in patients with RA. The first measurement of IMT was noted as IMT1, followed by a second measurement after 1 year, noted as IMT2. The group of patients was divided into approximately three equal groups, each being treated with a different biological product, respectively, etanercept, adalimumab, and infliximab. In the 3 groups, after 1 year of anti‑TNF‑α therapy, IMT2 progression was significantly reduced compared to baseline. No significant differences were found among the three groups of treatment. A strong association was observed between IMT1‑IMT2 in the etanercept group (P<0.001, r=0.758), in the adalimumab group (P<0.001, r=0.761) and in the infliximab group (P<0.001, r=0.829). The low level of Hcy2 after 12 months of anti‑TNF‑α therapy was significantly correlated with a decrease in IMT2 (P<0.001) in patients who had a high level of Hcy and IMT >0.9 mm at baseline. The results from the present study showed that biological treatment and the low level of homocysteinemia reduced the cardiovascular risk in RA, regardless of the treatment chosen (infliximab, adalimumab, or etanercept).
View Figures
View References

1 

Essouma M and Noubiap JJ: Therapeutic potential of folic acid supplementation for cardiovascular disease prevention through homocysteine-lowering and blockade in rheumatoid arthritis patients. Biomark Res. 3(24)2015.PubMed/NCBI View Article : Google Scholar

2 

Hayta E, Hizmetli S, Atalar MH and Çinar Z: Association of plasma homocysteine level and carotid intima-media thickness in rheumatoid arthritis patients receiving methotrexate. Arch Rheumatol. 3:214–220. 2015.

3 

Yang X, Gao F and Liu Y: Association of homocysteine with immunological-inflammatory and metabolic laboratory markers and factors in relation to hyperhomocysteinaemia in rheumatoid arthritis. Clin Exp Rheumatol. 33:900–903. 2015.PubMed/NCBI

4 

Snow MH and Mikuls TR: Rheumatoid arthritis and cardiovascular disease: The role of systemic inflammation and evolving strategies of prevention. Curr Opin Rheumatol. 17:234–241. 2005.PubMed/NCBI View Article : Google Scholar

5 

Pleșa CF, Nicolae C, Sîrbu CA, Nemeș R, Păunescu A and Țânțu MM: Use of anticoagulants in cerebral vascular pathology:. Farmacia. 67:27–33. 2019.

6 

Maradit-Kremers H, Nicola PJ, Crowson CS, Ballman KV and Gabriel SE: Cardiovascular death in rheumatoid arthritis: A population-based study. Arthritis Rheum. 52:722–732. 2005.PubMed/NCBI View Article : Google Scholar

7 

Lim TK, Lim E, Dwivedi G, Kooner J and Senior R: Normal value of carotid intima-media thickness-a surrogate marker of atherosclerosis: Quantitative assessment by B-mode carotid ultrasound. J Am Soc Echocardiogr. 21:112–126. 2008.PubMed/NCBI View Article : Google Scholar

8 

del Rincón I, Williams K, Stern MP, Freeman GL, O'Leary DH and Escalante A: Association between carotid atherosclerosis and markers of inflammation in rheumatoid arthritis patients and healthy subjects. Arthritis Rheum. 48:1833–1840. 2003.PubMed/NCBI View Article : Google Scholar

9 

Simon A, Gariepy J, Chironi G, Megnien JL and Levenson J: Intima-media thickness: A new tool for diagnosis and treatment of cardiovascular risk. J Hypertens. 20:159–169. 2002.PubMed/NCBI View Article : Google Scholar

10 

Popa C, Netea MG, van Riel PL, van der Meer JW and Stalenhoef AF: The role of TNF-alpha in chronic inflammatory conditions, intermediary metabolism, and cardiovascular risk. J Lipid Res. 48:751–762. 2007.PubMed/NCBI View Article : Google Scholar

11 

Linton MF, Yancey PG, Davies SS, Jerome WG, Linton EF, Song WL, Doran AC and Vickers KC: The role of lipids and lipoproteins in atherosclerosis. In: Endotext. Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dhatariya K, Dungan K, Grossman A, Hershman JM, Hofland J, et al (eds). MDText.com, Inc, South Dartmouth, MA, 2019.

12 

Giles JT, Post W, Blumenthal RS and Bathon JM: Therapy insight: Managing cardiovascular risk in patients with rheumatoid arthritis. Nat Clin Pract Rheumatol. 2:320–329. 2006.PubMed/NCBI View Article : Google Scholar

13 

Skeoch S, Cristinacce PLH, Williams H, Pemberton P, Xu D, Sun J, James J, Yuan C, Hatsukami T, Hockings PD, et al: Imaging atherosclerosis in rheumatoid arthritis: Evidence for increased prevalence, altered phenotype and a link between systemic and localised plaque inflammation. Sci Rep. 7(827)2017.PubMed/NCBI View Article : Google Scholar

14 

Hadi HA, Carr CS and Al Suwaidi J: Endothelial dysfunction: Cardiovascular risk factors, therapy, and outcome. Vasc Health Risk Manag. 3:183–198. 2005.PubMed/NCBI

15 

Saposnik G: The role of vitamin B in stroke prevention: A journey from observational studies to clinical trials and critique of the VITAmins TO Prevent Stroke (VITATOPS). Stroke. 42:838–842. 2011.PubMed/NCBI View Article : Google Scholar

16 

Selhub J: The many facets of hyperhomocysteinemia: Studies from the Framingham cohorts. J Nutr. 136 (Suppl 6):1726S–1730S. 2006.PubMed/NCBI View Article : Google Scholar

17 

Alvarez B, Yugueros X, Fernández E, Luccini F, Gené A and Matas M: Relationship between plasma homocysteine and the morphological and immunohistochemical study of carotid plaques in patients with carotid stenosis over 70%. Ann Vasc Surg. 26:500–505. 2012.PubMed/NCBI View Article : Google Scholar

18 

Eikelboom JW, Hankey GJ, Anand SS, Lofthouse E, Staples N and Baker RI: Association between high homocyst(e)ine and ischemic stroke due to large- and small-artery disease but not other etiologic subtypes of ischemic stroke. Stroke. 5:1069–1075. 2000.PubMed/NCBI View Article : Google Scholar

19 

Wu GH, Kong FZ, Dong XF, Wu DF, Guo QZ and Shen AR: Association between hyperhomocysteinemia and stroke with atherosclerosis and small artery occlusion depends on homocysteine metabolism-related vitamin levels in Chinese patients with normal renal function. Metab Brain Dis. 3:859–865. 2017.PubMed/NCBI View Article : Google Scholar

20 

Guin A, Chatterjee Adhikari M, Chakraborty S, Sinhamahapatra P and Ghosh A: Effects of disease modifying anti-rheumatic drugs on subclinical atherosclerosis and endothelial dysfunction which has been detected in early rheumatoid arthritis: 1-year follow-up study. Semin Arthritis Rheum. 43:48–54. 2013.PubMed/NCBI View Article : Google Scholar

21 

Kotani K, Miyamoto M and Ando H: The effect of treatments for rheumatoid arthritis on endothelial dysfunction evaluated by flow-mediated vasodilation in patients with rheumatoid arthritis. Curr Vasc Pharmacol. 15:10–18. 2017.PubMed/NCBI View Article : Google Scholar

22 

Sattin M and Towheed T: The effect of TNFα-inhibitors on cardiovascular events in patients with rheumatoid arthritis: An updated systematic review of the literature. Curr Rheumatol Rev. 12:208–222. 2016.PubMed/NCBI

23 

Popa C, Netea MG, Radstake T, Van der Meer JW, Stalenhoef AF, van Riel PL and Barerra P: Influence of anti-tumour necrosis factor therapy on cardiovascular risk factors in patients with active rheumatoid arthritis. Ann Rheum Dis. 2:303–305. 2005.PubMed/NCBI View Article : Google Scholar

24 

Dixon WG, Watson KD, Lunt M and Hyrich KL: British Society for Rheumatology Biologics Register Control Centre Consortium. Silman AJ and Symmons DP: British Society for Rheumatology Biologics Register. Reduction in the incidence of myocardial infarction in patients with rheumatoid arthritis who respond to anti-tumor necrosis factor alpha therapy: Results from the British society for rheumatology biologics register. Arthritis Rheum. 56:2905–2912. 2007.PubMed/NCBI View Article : Google Scholar

25 

Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO Jr, Birnbaum NS, Burmester GR, Bykerk VP, Cohen MD, et al: 2010 Rheumatoid arthritis classification criteria: An American college of rheumatology/european league against rheumatism collaborative initiative. Arthritis Rheum. 62:2569–2581. 2010.PubMed/NCBI View Article : Google Scholar

26 

Kang SS, Wong PW and Malinow MR: Hyperhomocyst(e)inemia as a risk factor for occlusive vascular disease. Annu Rev Nutr. 12:279–298. 1992.PubMed/NCBI View Article : Google Scholar

27 

Roubenoff R, Dellaripa P, Nadeau MR, Abad LW, Muldoon BA, Selhub J and Rosenberg IH: Abnormal homocysteine metabolism in rheumatoid arthritis. Arthritis Rheum. 40:718–722. 1997.PubMed/NCBI View Article : Google Scholar

28 

Haagsma CJ, Blom HJ, van Riel PL, van't Hof MA, Giesendorf BA, van Oppenraaij-Emmerzaal D and van de Putte LB: Influence of sulphasalazine, methotrexate, and the combination of both on plasma homocysteine concentrations in patients with rheumatoid arthritis. Ann Rheum Dis. 58:79–84. 1999.PubMed/NCBI View Article : Google Scholar

29 

Yang HT, Lee M, Hong KS, Ovbiagele B and Saver JL: Efficacy of folic acid supplementation in cardiovascular disease prevention: An updated meta-analysis of randomized controlled trials. Eur J Intern Med. 23:745–754. 2012.PubMed/NCBI View Article : Google Scholar

30 

Gonzalez-Gay MA, Gonzalez-Juanatey C, Piñeiro A, Garcia-Porrua C, Testa A and Llorca J: High-grade C-reactive protein elevation correlates with accelerated atherogenesis in patients with rheumatoid arthritis. J Rheumatol. 32:1219–1223. 2005.PubMed/NCBI

31 

Morgan SL, Baggott JE, Lee JY and Alarcón GS: Folic acid supplementation prevents deficient blood folate levels and hyperhomocysteinemia during longterm, low dose methotrexate therapy for rheumatoid arthritis: Implications for cardiovascular disease prevention. J Rheumatol. 25:441–446. 1998.PubMed/NCBI

32 

Ridker PM, Cushman M, Stampfer MJ, Tracy RP and Hennekens CH: Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med. 336:973–979. 1997.PubMed/NCBI View Article : Google Scholar

33 

Ballantyne CM, Hoogeveen RC, Bang H, Coresh J, Folsom AR, Heiss G and Sharrett AR: Lipoprotein-associated phospholipase A2, high-sensitivity C-reactive protein, and risk for incident coronary heart disease in middle-aged men and wome in the atherosclerosis risk in communities (ARIC) study. Circulation. 109:837–842. 2004.PubMed/NCBI View Article : Google Scholar

34 

Elliott P, Chambers JC, Zhang W, Clarke R, Hopewell JC, Peden JF, Erdmann J, Braund P, Engert JC, Bennett D, et al: Genetic loci associated with C-reactive protein levels and risk of coronary heart disease. JAMA. 302:37–48. 2009.PubMed/NCBI View Article : Google Scholar

35 

Virani SS, Pompeii L, Lincoln AE, Dunn RE, Tucker AM, Nambi V, Nasir K, Vogel RA, Boone JL, Roberts AJ and Ballantyne CM: Association between traditional cholesterol parameters, lipoprotein particle concentration, novel biomarkers and carotid plaques in retired national football league players. Atherosclerosis. 222:551–556. 2012.PubMed/NCBI View Article : Google Scholar

Related Articles

  • Abstract
  • View
  • Download
  • Twitter
Copy and paste a formatted citation
Spandidos Publications style
Anghel D, Sîrbu CA, Hoinoiu E, Petrache O, Pleșa C, Negru MM and Ioniţă‑Radu F: Influence of anti‑TNF therapy and homocysteine level on carotid intima‑media thickness in rheumatoid arthritis patients. Exp Ther Med 23: 59, 2022.
APA
Anghel, D., Sîrbu, C.A., Hoinoiu, E., Petrache, O., Pleșa, C., Negru, M.M., & Ioniţă‑Radu, F. (2022). Influence of anti‑TNF therapy and homocysteine level on carotid intima‑media thickness in rheumatoid arthritis patients. Experimental and Therapeutic Medicine, 23, 59. https://doi.org/10.3892/etm.2021.10981
MLA
Anghel, D., Sîrbu, C. A., Hoinoiu, E., Petrache, O., Pleșa, C., Negru, M. M., Ioniţă‑Radu, F."Influence of anti‑TNF therapy and homocysteine level on carotid intima‑media thickness in rheumatoid arthritis patients". Experimental and Therapeutic Medicine 23.1 (2022): 59.
Chicago
Anghel, D., Sîrbu, C. A., Hoinoiu, E., Petrache, O., Pleșa, C., Negru, M. M., Ioniţă‑Radu, F."Influence of anti‑TNF therapy and homocysteine level on carotid intima‑media thickness in rheumatoid arthritis patients". Experimental and Therapeutic Medicine 23, no. 1 (2022): 59. https://doi.org/10.3892/etm.2021.10981
Copy and paste a formatted citation
x
Spandidos Publications style
Anghel D, Sîrbu CA, Hoinoiu E, Petrache O, Pleșa C, Negru MM and Ioniţă‑Radu F: Influence of anti‑TNF therapy and homocysteine level on carotid intima‑media thickness in rheumatoid arthritis patients. Exp Ther Med 23: 59, 2022.
APA
Anghel, D., Sîrbu, C.A., Hoinoiu, E., Petrache, O., Pleșa, C., Negru, M.M., & Ioniţă‑Radu, F. (2022). Influence of anti‑TNF therapy and homocysteine level on carotid intima‑media thickness in rheumatoid arthritis patients. Experimental and Therapeutic Medicine, 23, 59. https://doi.org/10.3892/etm.2021.10981
MLA
Anghel, D., Sîrbu, C. A., Hoinoiu, E., Petrache, O., Pleșa, C., Negru, M. M., Ioniţă‑Radu, F."Influence of anti‑TNF therapy and homocysteine level on carotid intima‑media thickness in rheumatoid arthritis patients". Experimental and Therapeutic Medicine 23.1 (2022): 59.
Chicago
Anghel, D., Sîrbu, C. A., Hoinoiu, E., Petrache, O., Pleșa, C., Negru, M. M., Ioniţă‑Radu, F."Influence of anti‑TNF therapy and homocysteine level on carotid intima‑media thickness in rheumatoid arthritis patients". Experimental and Therapeutic Medicine 23, no. 1 (2022): 59. https://doi.org/10.3892/etm.2021.10981
Follow us
  • Twitter
  • LinkedIn
  • Facebook
About
  • Spandidos Publications
  • Careers
  • Cookie Policy
  • Privacy Policy
How can we help?
  • Help
  • Live Chat
  • Contact
  • Email to our Support Team