Relationship Between Rheumatoid Arthritis Treatments and Cardiovascular Health
Rheumatoid arthritis (RA) is a complex condition that not only affects the joints but also poses a risk to cardiovascular health. Inflammation plays a significant role in this increased risk. Understanding how the medications used to treat RA can impact cardiovascular markers is crucial for rheumatologists. Biologic and targeted synthetic drugs, commonly prescribed for RA, have the potential to modulate the immune system and may have broader effects on vascular function. Examining their impact on cardiovascular disease (CVD) risk is essential for optimizing patient care.
Methods: To gain insights into the relationship between RA treatments and cardiovascular health, a systematic review of existing studies was conducted. Scientific literature from reputable databases such as MedLine (via PubMed) and Web of Science was reviewed. The focus was on studies investigating the effects of biologic and targeted synthetic treatments approved for RA on various cardiovascular markers, such as endothelial function, arterial stiffness, and subclinical atherosclerosis. Considering the variability in study designs and outcome measures, a narrative synthesis approach was employed to analyze the findings.
Results: After careful examination and screening, 58 articles that met the criteria for inclusion in the review were identified. These studies provided valuable insights into the impact of biologic and targeted synthetic therapies on vascular dysfunction associated with RA. Overall, the findings suggest that these treatments may have a positive effect on improving endothelial function and reducing arterial stiffness, which are important indicators of cardiovascular health. However, the results regarding subclinical atherosclerosis, an early stage of cardiovascular disease, were inconsistent across the studies.
Conclusion: The systematic review sheds light on the potential cardiovascular benefits of biologic and targeted synthetic treatments for RA. While the exact mechanisms behind these effects are not yet fully understood, the evidence suggests that these therapies may help improve vascular dysfunction associated with RA. It is important to note, however, that their impact on subclinical atherosclerosis requires further investigation.
As rheumatologists, these findings have important implications for clinical practice. They underscore the potential cardiovascular benefits of biologic and targeted synthetic treatments in managing RA. When developing treatment plans for patients, healthcare providers should take into consideration the impact of these medications on cardiovascular markers. However, it is crucial to consider individual patient characteristics and comorbidities when making treatment decisions. Consulting with a rheumatologist or healthcare provider remains essential for personalized care and treatment optimization.
Reference:
Gerganov, G., Georgiev, T., Dimova, M. et al. Vascular effects of biologic and targeted synthetic antirheumatic drugs approved for rheumatoid arthritis: a systematic review. Clin Rheumatol (2023). https://doi.org/10.1007/s10067-023-06587-8
Tags: rheumatoid arthritis, biologics, treatment, tsDMARDs