Aims: To assess the effect (week 12/week 24) of puerarin on carotid intima-media thickness (CIMT) in rheumatoid arthritis (RA). Methods: In the open, controlled, randomized and parallel-group comparison study, 119 consecutive RA patients under routine antirheumatic care were randomized to receive treatment either with (n = 60, 16 males and 44 females; mean age: 52.97 years, 95% CI 49.78 to 56.15) or without (n = 59, 17 males and 42 females, mean age: 54.05 years, 95% CI 50.03 to 58.07) 400 mg puerarin. The effect of both interventions on carotid intima-media thickness (CIMT) and homeostasis model assessment of insulin resistance (HOMA-IR) value were compared at entry, 12 and 24 weeks. Results: No significant side effects occurred concerning the use of puerarin, and both interventions were generally well tolerated in all the patients. Tiny but significant decrease of CIMT was observed in puerarin-treated patients at 24 weeks (-0.003 mm, 95% CI -0.005 to -0.001 vs. 0.019 mm, 95% CI -0.002 to 0.040, p<0.001). At 24 weeks, insulin resistance was indicated with more pronounced improvement in puerarin group vs. control (homeostasis model assessment, -0.40, 95% CI -0.47 to -0.33 vs. -0.05, 95% CI -0.08 to -0.01 p < 0.001). Correlation analysis indicated an interaction between the parallel reductions in CIMT and insulin resistance in puerarin group (r = 0.878, p < 0.001), but not in control. Conclusion: In the study, 24 weeks of treatment with 400 mg puerarin exerted significant effect on preventing CIMT progression in active RA patients, which may be associated with the improvement of insulin resistance. Puerarin holds promise as a drug candidate for the prevention and treatment of cardiometabolic comorbidities in RA patients.
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This was a 24-week, randomized and controlled parallel trial registered with ClinicalTrials.gov, NCT02254655