Biologic Use Linked to Reduced Cardiovascular Risk in Inflammatory Arthritis

Heart CT scan
Heart CT scan
Current biologic use was associated with a reduction in major cardiovascular events in patients with inflammatory arthritis.

Patients with inflammatory arthritis who are currently using biologics have a significantly decreased risk for cardiovascular (CV) events, according to study results published in Arthritis Research & Care.

The study included participants with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) from the Australian Rheumatology Association Database (n=4140). The researchers used a Cox proportional hazards model to test for risk for CV events, which they defined as angina, myocardial infarction, coronary artery bypass graft, percutaneous coronary intervention, other heart disease, stroke or transient ischemic attack, or death from CV causes. They adjusted for age, sex, diagnosis, methotrexate use, prednisone use, nonsteroidal anti-inflammatory use, smoking status, alcohol consumption, hypertension, hyperlipidemia, diabetes, and functional status (Health Assessment Questionnaire Disability Score).

The 4140 participants contributed a total of 19,627 patient-years. The researchers found that participants who used tumor necrosis factor (TNF) inhibitors or other biologic therapies had a reduced risk for CV events (HR, 0.85; 95% CI, 0.76-0.95; and HR, 0.81; 95% CI, 0.70-0.95, respectively).

In addition, participants who had stopped biologic therapy did not have a reduced risk for CV events (HR, 0.96; 95% CI, 0.83-1.11).

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After adjustment, the results did not indicate a significant difference in CV event risk between participants with RA and PsA (HR, 0.92; 95% CI, 0.77-1.10) or AS (HR, 1.14; 95% CI, 0.96-1.36).

“These findings support the hypothesis that control of systemic inflammation in these conditions may reduce the cardiovascular risk,” the researchers wrote.

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Lee JL, Sinnathurai P, Buchbinder R, et al. Biologics and cardiovascular events in inflammatory arthritis: a prospective national cohort study [published online August 7, 2018]. Arthr Res Ther. doi:10.1186/s13075-018-1669-x