Most people with rheumatoid arthritis (RA) who take biologic drugs do so because they want to feel better and slow the progression of their illness. While that’s certainly the primary purpose of these drugs — which target specific parts of the immune system that drive inflammation, such as proteins known as tumor necrosis factor (TNF) and certain interleukins (IL-1 and IL-6), among others — new research suggests that these meds might provide a bonus benefit: They seem to lower the risk of cardiovascular disease.
RA patients — especially those whose disease is not well-controlled — generally face a higher than average risk of cardiovascular disease thanks to high levels of inflammation throughout the body. In fact, older research has shown that in half of people with RA who end up dying prematurely, cardiovascular disease is to blame.
In a new study, published in the journal Arthritis & Rheumatology, scientists at UCLA had 150 RA patients undergo heart scans (CT angiograms); 101 of them had another scan about seven years later. The authors then compared scan findings between those who were on biologic drugs and those who were not. (Those who were not using biologics might have been on other treatments, such as traditional DMARDs and/or NSAIDs.) They also compared the rate of cardiovascular events (including heart attacks, strokes, and heart failure) between the two groups.
According to their research, RA patients who were taking biologics were less apt to develop a buildup of dangerous plaque in their arteries.
The authors also calculated each patient’s likelihood of suffering a cardiovascular event within the next 10 years (Framingham-D’Agostino score) and determined that those using biologics had a lower risk of future cardiac events.
Why biologics confer this benefit isn’t entirely clear, but “it is possible that biologic DMARDs have a direct protective effect on the arterial wall” by slowing the buildup of plaque or helping to keep plaque stable so it’s less apt to break off and lead to a heart attack or stroke, the authors speculated.
Although there’s no guarantee that biologics used to treat RA will protect your heart, it may be worth discussing with your doctor.
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Karpouzas G, et al. Biologics May Prevent Cardiovascular Events in Rheumatoid Arthritis by Inhibiting Coronary Plaque Formation and Stabilizing High‐Risk Lesions. Arthritis & Rheumatology. September 2020. doi: https://doi.org/10.1002/art.41293.
Symmons D, et al. Epidemiology of CVD in rheumatic disease, with a focus on RA and SLE. Nature Reviews Rheumatology. July 2011. doi: https://doi.org/10.1038/nrrheum.2011.75.