[Rheumatic diseases, inflammation and cardiovascular risk]

Area of Science:

• Rheumatology
• Cardiology
• Immunology

Background:

• Patients with inflammatory arthritis (IA) exhibit elevated cardiovascular disease (CVD) risk compared to the general population.
• Despite awareness for over a decade, CVD morbidity and mortality in IA patients remain a significant concern.
• Current cardiovascular risk assessment tools often underestimate risk in IA patients, highlighting the need for specialized approaches.

Purpose of the Study:

• To review the cardiovascular risk profile in patients with inflammatory arthritis.
• To discuss the limitations of current cardiovascular risk assessment in IA.
• To explore the impact of antirheumatic drugs on cardiovascular risk in IA.

Main Methods:

• Literature review and synthesis of existing data on cardiovascular risk in inflammatory arthritis.
• Analysis of the role of inflammation as an independent cardiovascular risk factor.
• Evaluation of the cardiovascular effects of various antirheumatic drug classes, including biologics, methotrexate, and janus kinase inhibitors.

Main Results:

• Inflammation is an independent cardiovascular risk factor, but its incorporation into risk scores has not yet improved prediction.
• Biologic therapies, particularly tumor necrosis factor α inhibitors, demonstrate a notable protective effect, reducing cardiovascular event rates by 15%.
• Methotrexate may also offer a protective effect, though data is less robust; janus kinase inhibitors require further investigation.

Conclusions:

• Cardiovascular risk management in inflammatory arthritis patients is crucial for general practitioners, rheumatologists, and researchers.
• Development of specific risk assessment tools for IA patients is needed.
• Antirheumatic drugs, especially biologics, can positively influence cardiovascular outcomes in IA patients.