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Shared inflammatory pathways of rheumatoid arthritis and atherosclerotic cardiovascular disease

Brittany N Weber1, Jon T Giles2, Katherine P Liao3,4

  • 1Division of Cardiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.

Nature Reviews. Rheumatology
|May 25, 2023
PubMed

Insights

Targeting inflammation pathways like IL-6 can reduce cardiovascular disease risk in rheumatoid arthritis (RA) patients and the general population. This review examines key inflammatory pathways and their cardiovascular implications.

Area of Science:

  • Rheumatology
  • Cardiology
  • Immunology

Background:

  • Chronic inflammation is a known risk factor for cardiovascular disease (CVD) in rheumatoid arthritis (RA) and the general population.
  • Targeted therapies for RA offer insights into how inhibiting specific inflammatory pathways affects cardiovascular risk.

Purpose of the Study:

  • To review pro-inflammatory pathways targeted in RA therapies.
  • To examine the role of these pathways in RA pathogenesis and atherosclerotic cardiovascular disease (ASCVD).
  • To assess the impact of inhibiting these pathways on cardiovascular risk.

Main Methods:

  • Review of existing RA therapies targeting specific pro-inflammatory pathways.
  • Analysis of mechanistic data from the general population regarding these pathways and CVD.
  • Focus on Interleukin-1 (IL-1), Interleukin-6 (IL-6), Tumor Necrosis Factor (TNF), and Janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathways.

Main Results:

  • Robust data support IL-1 and IL-6 inhibition in reducing cardiovascular disease risk.
  • Growing evidence indicates IL-6 inhibition benefits both RA patients and the general population in lowering CVD risk.

Conclusions:

  • Inhibition of IL-1 and IL-6 pathways shows promise in mitigating cardiovascular risk associated with inflammation.
  • Targeting IL-6, in particular, presents a viable strategy for cardiovascular risk management in both RA and the general populace.

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