Rheumatoid arthritis drug has added benefits

By Piriya Mahendra

Treatment with anti-tumor necrosis factor (TNF) drugs reduces the risk for cardiovascular (CV) events in patients with rheumatoid arthritis (RA), researchers report.

The retrospective analysis was presented at the European League Against Rheumatism (EULAR) Annual Congress 2012, and showed that the cumulative use of anti-TNFs for 1, 2, and 3 years is associated with 24%, 42%, and 56% reduced risk for CV events, respectively, compared with not using anti-TNFs in RA patients.

A multivariate regression model that was based on 109,462 patients demonstrated that each additional 6 months of anti-TNF treatment significantly reduced the risk for CV events, including myocardial infarction (MI), stroke/transient ischemic attack, unstable angina, or heart failure, by 13% (p=0.005).

Specifically, the model showed that the risk for MI was decreased by a significant 20% for each additional 6 months of anti-TNF treatment (p=0.013).

Subgroup analyses revealed that RA patients aged at least 50 years had a 14% reduced risk for CV events, and patients who had not been previously treated with methotrexate had a 15% reduced risk for CV events (p<0.022).

"RA and heart disease have a common origin and the systemic inflammation involved in RA is thought to also promote CV disease and even CV death," commented lead author Michael Nurmohamed (VU University Medical Center, The Netherlands) in a press statement.

"As anti-TNFs are now the treatment of choice for patients who are unstable on methotrexate, the decreased CV risk observed in the study is an added bonus to an already successful class of drugs."

The study included patients with at least two RA diagnoses and at least one filled prescription of anti-TNF therapy, methotrexate therapy, or other nonbiologic disease modifying anti-rheumatic drug.

All patients were assessed from index fill date to first inpatient CV-event diagnosis, the end of health plan enrolment, or to 6 months after discontinuation of their index drug, whichever came first.

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