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Biological use infl...
Biological use influences the impact of inflammation on risk of major adverse cardiovascular events in rheumatoid arthritis
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- Karpouzas, George Athanasios (author)
- Internal Medicine - Rheumatology, CA, Torrance, United States; Harbor-UCLA Medical Center, Rheumatology, CA, Torrance, United States
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- Ormseth, Sarah R. (author)
- CA, Torrance, United States
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- van Riel, Piet Leonardus Cornelis Maria (author)
- IQ Healthcare, Radboud University, Gelderland, Nijmegen, Netherlands; Bernhoven Hospital Location Oss, Rheumatology, Oss, Netherlands
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- Gonzalez-Gay, Miguel A. (author)
- Rheumatology, Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Spain; IIS-Fundacion Jimenez Diaz, Madrid, Spain
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- Corrales, Alfonso (author)
- Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Spain
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- Rantapää-Dahlqvist, Solbritt (author)
- Umeå universitet,Reumatologi
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- Sfikakis, Petros P. (author)
- First Dept. of Propedeutic Medicine, University of Athens, Attica, Athens, Greece
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- Dessein, Patrick (author)
- School of Physiology, University of the Witwatersrand Johannesburg, Johannesburg, South Africa
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- Tsang, Linda (author)
- Vrije Universiteit Brussel, Belgium
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- Hitchon, Carol (author)
- University of Manitoba, Rheumatology, MB, Winnipeg, Canada
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- El-Gabalawy, Hani (author)
- Department of Internal Medicine, University of Manitoba, MB, Winnipeg, Canada
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- Pascual-Ramos, Virginia (author)
- Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
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- Contreras-Yáñez, Irazú (author)
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Mexico
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- Colunga-Pedraza, Iris J. (author)
- Hospital Universitario Dr José Eleuterio González, Rheumatology, Nuevo León, Monterrey, Mexico
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- Galarza-Delgado, Dionicio Angel (author)
- Hospital Universitario Dr Jose Eleuterio Gonzalez, Rheumatology, Nuevo León, Monterrey, Mexico
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- Azpiri-Lopez, Jose Ramon (author)
- Hospital Universitario Dr José Eleuterio González, Nuevo León, Monterrey, Mexico
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- Semb, Anne Grete (author)
- Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
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- Misra, Durga Prasanna (author)
- Clinical Immunology and Rheumatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Uttar Pradesh, Lucknow, India
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- Hauge, Ellen-Margrethe (author)
- Department of Joint and Connective Tissue Diseases, Aarhus Universitetshospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus Universitet, Aarhus, Denmark
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- Kitas, George (author)
- Department of Rheumatology, Dudley Group NHS Foundation Trust, West Midlands, Dudley, United Kingdom
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(creator_code:org_t)
- BMJ Publishing Group Ltd, 2024
- 2024
- English.
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In: RMD Open. - : BMJ Publishing Group Ltd. - 2056-5933. ; 10:3
- Related links:
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Objectives: Chronic inflammation promotes cardiovascular risk in rheumatoid arthritis (RA). Biological disease-modifying antirheumatic drugs (bDMARDs) improve disease activity and cardiovascular disease outcomes. We explored whether bDMARDs influence the impact of disease activity and inflammatory markers on long-term cardiovascular risk in RA.Methods: We studied 4370 participants without cardiovascular disease in a 10-country observational cohort of patients with RA. Endpoints were (1) major adverse cardiovascular events (MACE) encompassing myocardial infarction, stroke and cardiovascular death; and (2) any ischaemic cardiovascular events (iCVE) including MACE plus revascularisation, angina, transient ischaemic attack and peripheral arterial disease.Results: Over 26 534 patient-years, 239 MACE and 362 iCVE occurred. The interaction between 28-joint Disease Activity Score with C-reactive protein (DAS28-CRP) and bDMARD use was significant for MACE (p=0.017), suggesting the effect of DAS28-CRP on MACE risk differed among bDMARD users (n=515) and non-users (n=3855). DAS28-CRP (per unit increase) is associated with MACE risk in bDMARD non-users (HR 1.21 (95% CI 1.07 to 1.37)) but not users (HR 0.69 (95% CI 0.40 to 1.20)). The interaction between CRP (per log unit increase) and bDMARD use was also significant for MACE (p=0.011). CRP associated with MACE risk in bDMARD non-users (HR 1.16 (95% CI 1.04 to 1.30)), but not users (HR 0.65 (95% CI 0.36 to 1.17)). No interaction was observed between bDMARD use and DAS28-CRP (p=0.167) or CRP (p=0.237) for iCVE risk.Conclusions: RA activity and inflammatory markers associated with risk of MACE in bDMARD non-users but not users suggesting the possibility of biological-specific benefits locally on arterial wall independently of effects on systemic inflammation.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
Keyword
- Arthritis
- Rheumatoid
- Biological Therapy
- Cardiovascular Diseases
- Inflammation
Publication and Content Type
- ref (subject category)
- art (subject category)
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Karpouzas, Georg ...
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Ormseth, Sarah R ...
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van Riel, Piet L ...
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Gonzalez-Gay, Mi ...
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Corrales, Alfons ...
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Rantapää-Dahlqvi ...
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Sfikakis, Petros ...
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Dessein, Patrick
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Tsang, Linda
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Hitchon, Carol
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El-Gabalawy, Han ...
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Pascual-Ramos, V ...
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Contreras-Yáñez, ...
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Colunga-Pedraza, ...
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Galarza-Delgado, ...
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Azpiri-Lopez, Jo ...
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Semb, Anne Grete
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Misra, Durga Pra ...
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Hauge, Ellen-Mar ...
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Kitas, George
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Rheumatology and ...
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RMD Open
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Umeå University