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Targeting inflammation in the prevention of cardiovascular disease in patients with inflammatory arthritis

Jiayun Shen1, Qing Shang1, Lai-Shan Tam1

  • 1Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.

Translational Research : the Journal of Laboratory and Clinical Medicine
|June 9, 2015
PubMed

Insights

Patients with inflammatory arthritis face higher cardiovascular disease (CVD) risks. This review examines how biologic therapies, including anti-TNF and non-TNF drugs, impact cardiovascular health in these patients.

Area of Science:

  • Rheumatology
  • Cardiology
  • Immunology

Background:

  • Patients with inflammatory arthritis exhibit elevated cardiovascular disease (CVD) risks compared to the general population.
  • Subclinical atherosclerosis and arterial stiffness are prevalent in inflammatory arthritis, potentially serving as surrogate endpoints for cardiovascular events.
  • Persistent systemic inflammation and dysregulated innate immunity in inflammatory arthritis are implicated in accelerating atherosclerosis and CVD development.

Purpose of the Study:

  • To review the effects of biologic disease-modifying antirheumatic drugs (bDMARDs) on the cardiovascular system in patients with inflammatory arthritis.
  • To evaluate the impact of anti-tumor necrosis factor (TNF) therapies and non-TNF biologics on traditional CVD risk factors, endothelial function, arterial stiffness, subclinical atherosclerosis, and clinical CVD.
  • To clarify the role of anti-TNF therapy in preventing CVD in rheumatoid arthritis and spondyloarthritis.

Main Methods:

  • Systematic review of existing literature on biologic therapies and cardiovascular outcomes in inflammatory arthritis.
  • Analysis of studies investigating the effects of anti-TNF and non-TNF biologics on various cardiovascular parameters.
  • Synthesis of data regarding clinical cardiovascular events in patients treated with different classes of biologics.

Main Results:

  • Biologic therapies, particularly anti-TNF agents, have shown promise in improving cardiovascular outcomes in rheumatoid arthritis.
  • Data on the cardiovascular effects of non-TNF biologics are still limited, necessitating further research.
  • The precise impact of anti-TNF therapy on CVD prevention in spondyloarthritis requires additional investigation.

Conclusions:

  • Effective inflammation suppression with biologics has improved disease outcomes in inflammatory arthritis.
  • Anti-TNF therapy may offer cardiovascular benefits in certain inflammatory arthritis populations, but more research is needed for non-TNF biologics and spondyloarthritis.
  • Further studies are crucial to fully elucidate the cardiovascular protective potential of various biologic therapies in inflammatory arthritis.

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