| Full text | |
| Author(s): |
de Faria, Ana Paula
[1]
;
Ritter, V, Alessandra M.
;
Santa-Catharina, Arthur
[2]
;
Souza, Debora P.
[2]
;
Naseri, Estephania P.
[2]
;
Bertolo, Manoel B.
[2]
;
Pioli, Mariana Rodrigues
[2]
;
Carvalho, Caio C.
[3]
;
Modolo, Rodrigo
[2]
;
Moreno, Heitor
[2]
Total Authors: 10
|
| Affiliation: | [1] Univ Estadual Campinas, Campinas, SP - Brazil
[2] Ritter, Alessandra M., V, Univ Estadual Campinas, Campinas, SP - Brazil
[3] Univ Sao Paulo, Ribeirao Preto, SP - Brazil
Total Affiliations: 3
|
| Document type: | Journal article |
| Source: | Arquivos Brasileiros de Cardiologia; v. 116, n. 3, p. 443-451, MAR 2021. |
| Web of Science Citations: | 1 |
| Abstract | |
Abstract Background: The cytokine tumor necrosis factor-alpha (TNF-α) is elevated in resistant hypertension (RH), but the effects of a TNF-α inhibitor in this population is unknown. Objective: The aim of this trial was to evaluate whether a single dose of infliximab controlled by placebo acutely reduces blood pressure (BP) in RH subjects. Methods: A double-blind, placebo-controlled, crossover trial was conducted, and randomized RH subjects received either infliximab or placebo. The primary endpoint was the change in mean BP levels relative to the baseline immediately after the infusion obtained by continuously beat-to-beat non-invasive hemodynamic assessment. Secondary endpoints included changes in office, ambulatory and central BP measurements; endothelial function; and inflammatory biomarkers after 7 days. The level of significance accepted was alpha=0.05. Results: Ten RH subjects were enrolled. The primary endpoint analysis showed an acute decrease in mean BP values (mean of differences ± standard deviation = -6.3 ± 7.2 mmHg, p=0.02) from baseline, after the application of infliximab compared with placebo. Diastolic BP levels (-4.9 ± 5.5 mmHg, p=0.02), but not systolic BP levels (-9.4 ± 19.7 mmHg, p=0.16), lowered after infliximab infusion. No further significant differences were identified in either the other hemodynamic parameters or in secondary endpoints, except for TNF-α levels, which increased continuously after infliximab infusion. No adverse events were reported during the protocol. Conclusions: A single-dose of infliximab decreased the mean and diastolic BP levels immediately after its infusion, when compared to the placebo in RH. The anti-TNF-α therapy was found to be safe and well-tolerated. The results of this proof-of-concept are hypothesis-generating and need to be further investigated. (Arq Bras Cardiol. 2021; 116(3):443-451) (AU) | |
| FAPESP's process: | 15/17151-7 - Effects of the TNF-alpha inhibiton on blood pressure, hemodynamic parameters and biomarkers in resistant hypertension |
| Grantee: | Ana Paula Cabral de Faria Modolo |
| Support Opportunities: | Scholarships in Brazil - Post-Doctoral |