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Friday, October 9, 2015

Study probes link between rheumatoid arthritis medication, cardiovascular events

INDIANAPOLIS – Does tightly controlling rheumatoid arthritis (RA) have an effect on the level of risk for heart attack and stroke?  It’s possible, according to a recently published study appearing in the medical journal, Arthritis & Rheumatology.
The analysis evaluated associations between  RA disease activity, inflammation and lipid levels among patients taking tocilizumab (Actremra), to determine if that therapy affects their risks for major adverse cardiovascular events.

Tocilizumab, an immunosuppressive drug that blocks inflammation, is used for treating RA, a chronic inflammatory disorder causing inflammation in the joints and resulting in painful deformity and immobility in the fingers, wrists, feet and ankles.

The analysis showed that decreasing inflammation is related to lower risk of cardiovascular events even though RA patients on tocilizumab showed increased lipid levels. 

“Patients with rheumatoid arthritis have two-to-three fold the risk of myocardial infarction (heart attack) and stroke compared with those in the general population,” said Vijay U. Rao, MD, PhD, the study’s principal author and a member of Franciscan Physician Network Indiana Heart Physicians. “These findings are important to patients with RA, rheumatologists and cardiologists because it supports the link between inflammation and cardiovascular disease, a huge area of research right now. Keeping the condition under control can help decrease a patient’s risk of cardiovascular events, regardless of their cholesterol levels.

Dr. Rao and his research colleagues evaluated data pooled from 3,986 adult patients having moderate to severe RA and who received tocilizumab intravenously every four weeks in randomized controlled trials and studies.

Several previous studies suggest that the increased incidence of cardiovascular disease in RA patients is not completely explained by traditional risk factors such as diabetes mellitus, hypertension and smoking, but now we have shown support for the link between inflammation and cardiovascular disease,” Dr. Rao said. “Larger studies are needed to confirm these findings.”

The study was conducted during Dr. Rao’s research fellowship with Genentech.