The RA Heart Left Unprotected

TNF inhibitors may not reduce heart disease risk in early rheumatoid arthritis

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) The inflammation of rheumatoid arthritis can affect more than the joints; it also poses a threat to the heart. When it comes to protecting the heart health of rheumatoid arthritis patients, certain drugs are falling short.

Rheumatoid arthritis patients treated with a class of anti-inflammatory drugs called tumor necrosis factor (TNF) inhibitors did not have a reduced risk of heart disease.

"Take care of your heart if you have rheumatoid arthritis."

People with rheumatoid arthritis have an increased risk of heart disease. Over the years, researchers have been studying the relationship between the risk of heart disease and treatment with TNF inhibitors in people with established rheumatoid arthritis.

The results of these studies have been conflicting. On top of that, there has been little research on TNF inhibitor therapy and heart disease risk in people with early rheumatoid arthritis. For this reason, Lotta Ljung, M.D., of Umea University Hospital in Sweden, and colleagues wanted to see if TNF inhibitor therapy had an effect on the risk of heart-related problems in patients with early rheumatoid arthritis.

They found that TNF inhibitor therapy was not associated with any difference in the risk of complications from atherosclerosis (narrowed arteries), such as heart attack.

It is possible there was no decrease in the risk of heart-related events because some patients did not respond to the TNF inhibitors. However, Dr. Ljung and colleagues covered that ground: even patients who responded to TNF inhibitor therapy saw no change to their risk.

For their study, the Swedish team of researchers conducted a two-part study. First, they studied a cohort of 6,000 patients diagnosed with rheumatoid arthritis between 1999 and 2007.

They compared the risk of heart-related events in patients treated with anti-TNF drugs to that risk in those not treated with anti-TNF drugs. Second, the researchers ran a nested case-control study in which they looked at the relationship between response to TNF inhibitors and the risk of heart-related events.

"In this study of patients treated with anti-TNF within the first years of [rheumatoid arthritis], neither treatment with, nor response to, anti-TNF therapy could be linked to any statistically significant decrease in the risk of ACS," the authors write.

In other words, neither exposure to nor response to TNF inhibitors reduced the risk of heart-related events in people with early rheumatoid arthritis.

The full results of the study are published in the journal Arthritis & Rheumatism.

Reviewed by: 
Review Date: 
January 3, 2012
Last Updated:
January 6, 2012