Inflammatory arthritis: biologics tied to reduced cardiovascular events

  • Lee JL & al.
  • Arthritis Res Ther
  • 7 Aug 2018

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • Current use of biological therapies may protect against cardiovascular events (CVEs) in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS).

Why this matters

  • Biological therapies may carry benefits beyond antiarthritic effects.
  • The protection against CVEs may be because of a reduction of systemic inflammation.

Study design

  • Prospective national cohort (n=4140) of consecutive participants in the Australian Rheumatology Association Database with RA, PsA, and AS.
  • Biologic therapies were anti-TNF therapies and others (anakinra, rituximab, abatacept, tocilizumab).
  • CVEs were angina, myocardial infarction, coronary artery bypass graft, percutaneous coronary intervention, other heart disease, stroke/transient ischemic attack, or death from cardiovascular causes.
  • Funding: AbbVie; Pfizer; Sanofi; Bristol-Myers Squibb.

Key results

  • Follow-up totaled 19,627 patient-years.
  • Risk reduction was seen for CVEs with current use of anti-TNF therapy (HR, 0.85; 95% CI, 0.76-0.95) or other biologic therapies (HR, 0.81; 95% CI, 0.70-0.95) compared with biologics-naive patients after multivariate adjustment.
  • There was no significant risk reduction in those who ceased biologic therapies (HR, 0.96; 95% CI, 0.83-1.11).
  • No significant difference in CVE rates was found between RA and PsA (HR, 0.92; 95% CI, 0.77-1.10) or between RA and AS (HR, 1.14; 95% CI, 0.96-1.36).

Limitations

  • Observational design.
  • Self-reports only.

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