Disease-modifying anti-rheumatic drugs improve the cardiovascular profile in patients with rheumatoid arthritis

Bibliographic Details
Title: Disease-modifying anti-rheumatic drugs improve the cardiovascular profile in patients with rheumatoid arthritis
Authors: Andrea Giachi, Massimo Cugno, Roberta Gualtierotti
Source: Frontiers in Cardiovascular Medicine, Vol 9 (2022)
Publisher Information: Frontiers Media S.A., 2022.
Publication Year: 2022
Collection: LCC:Diseases of the circulatory (Cardiovascular) system
Subject Terms: rheumatoid arthritis, cardiovascular disease, atherosclerosis, DMARDs, TNF inhibitors, JAK inhibitors, Diseases of the circulatory (Cardiovascular) system, RC666-701
More Details: Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting about 0. 5–1% of the adult population and manifesting as persistent synovitis, systemic inflammation and production of autoantibodies. Patients affected by RA not only experience chronic disease progression, but are also burdened by a 1.5-fold increased cardiovascular (CV) risk, which is comparable to the risk experienced by patients with type 2 diabetes mellitus. RA patients also have a higher incidence and prevalence of coronary artery disease (CAD). Although RA patients frequently present traditional CV risk factors such as insulin resistance and active smoking, previous studies have clarified the pivotal role of chronic inflammation–driven by proinflammatory cytokines such as interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-alpha)–in accelerating the process of atherosclerosis and impairing the coagulation system. Over the last years, a number of studies have shown that disease-modifying anti-rheumatic drugs (DMARDs) reducing the inflammatory state in general improve the CV risk, however some drugs may carry some apparent negative effects. Thus, RA is a model of disease in which targeting inflammation may counteract the progression of atherosclerosis and reduce CV risk. Clinical and experimental evidence indicates that the management of RA patients should be tailored based on the positive and negative effects of DMARDs on CV risk together with the individual traditional CV risk profile. The identification of genetic, biochemical and clinical biomarkers, predictive of evolution and response to treatment, will be the next challenge for a precision approach to reduce the burden of the disease.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2297-055X
Relation: https://www.frontiersin.org/articles/10.3389/fcvm.2022.1012661/full; https://doaj.org/toc/2297-055X
DOI: 10.3389/fcvm.2022.1012661
Access URL: https://doaj.org/article/cce9f6eddf384e85b3c4e25cf1667406
Accession Number: edsdoj.9f6eddf384e85b3c4e25cf1667406
Database: Directory of Open Access Journals
More Details
ISSN:2297055X
DOI:10.3389/fcvm.2022.1012661
Published in:Frontiers in Cardiovascular Medicine
Language:English