Title:Cardiovascular Effects of Biologic Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
VOLUME: 18 ISSUE: 5
Author(s):Maria Drakopoulou, Stergios Soulaidopoulos, George Oikonomou, Dimitrios Tousoulis and Konstantinos Toutouzas*
Affiliation:First Department of Cardiology, Athens School of Medicine, Hippokration Hospital, Athens, First Department of Cardiology, Athens School of Medicine, Hippokration Hospital, Athens, First Department of Cardiology, Athens School of Medicine, Hippokration Hospital, Athens, First Department of Cardiology, Athens School of Medicine, Hippokration Hospital, Athens, First Department of Cardiology, Athens School of Medicine, Hippokration Hospital, Athens
Keywords:Cardiovascular disease, rheumatoid arthritis, biologic disease-modifying agents, tumor necrosis factor, atherosclerosis.
Abstract:The risk of cardiovascular (CV) disease is increased among patients with systemic autoimmune
rheumatic diseases and remains an underserved area of medical need. Although traditional risk
factors for CV disease, such as hypertension, smoking, dyslipidemia and obesity contribute to endothelial
dysfunction in rheumatoid arthritis (RA), they are not enough on their own to explain the observed
excess CV risk. Rather, systemic inflammation seems to play a pivotal role in both disease states. Considering
the inflammatory process in autoimmune diseases, scientific interest has focused on recently
introduced biologic disease-modifying agents (bDMARDS) such as inhibitors of Tumor Necrosis Factor-
α (ΤΝF-α), Interleukins -1 (IL-1) and -6 (IL-6). Despite the widespread use of bDMARDS in RA
and other chronic autoimmune inflammatory diseases, their precise impact on CV disease and outcome
remains to be elucidated, while prospective randomized control trials assessing their impact on hard CV
endpoints are scarce. In this review, we summarize current knowledge concerning the effect of
bDMARDs on CV outcome and on the risk of developing CV disease in patients with systemic autoimmune
rheumatic diseases.