News Video | Policy | GPs | Hospitals | Medical | Mental Health | Welfare | Search


Reducing Cardio Risk With Common Rheumatoid Arthritis Therapies

New advice on arthritis drugs

Study checks rheumatoid arthritis heart-stroke risk

New research evaluating the drugs commonly used by rheumatoid arthritis patients suggests two combinations could reduce the risk of heart attack and strokes.

The new publication in Frontiers in Cardiovascular Medicine has found that anti-rheumatic drug regimens that include either tumour necrosis factor inhibitors or hydroxychloroquine might significantly protect the endothelium in rheumatoid arthritis.

Occurring in about one in 100 people, rheumatoid arthritis (RA) is a common autoimmune disease which leads to inflammation and pain in the connective tissue of a patient’s joints.

“Rheumatoid arthritis patients have an increased risk of atherosclerosis (clogged arteries) and cardiovascular disease when compared to the general population, probably due to an excess of inflammation in patients with this condition,” says chief investigator Professor Gian Luca Erre, national coordinator of the Evaluation for Coronary Heart Disease Risk Estimation in Rheumatoid Arthritis (EDRA) study.

The Italian and Australian research evaluated five different types of anti-rheumatic drug usage groups in a group of 868 rheumatoid arthritis patients in a national Italian study.

“This excess of inflammation is not limited to the joints, but also involves the blood vessels leading to dysfunction in the inner layer of blood vessels (the endothelial),” says University of Sassari Professor of Rheumatology Gian Luca Erre.

Drugs prescribed for rheumatoid arthritis (anti-rheumatic drugs) typically have anti-inflammatory effects and may potentially protect the endothelium, reducing the risk of atherosclerosis in these patients.

“However, most patients take several anti-rheumatic drugs at once. Hence, it is difficult to see which specific agent is better than others at protecting the endothelium.”

Links between anti-rheumatics and endothelium were studied in five types of anti-rheumatic drug usage (groups) in the EDRA study – a multicentre study of Italian patients with rheumatoid arthritis, led by the University of Sassari.

The endothelial function was relatively preserved in two of these groups – that is, those with the tumour necrosis factor inhibitors and use of hydroxychloroquine.

Drugs used to treat RA’s debilitating pain in millions of patients around the world might have protective cardiovascular effects however these can be variable, as also shown in our study, says Flinders University Professor of Pharmacology Arduino Mangoni.

“Prospective studies are now required to test whether such regimens are also able to curb the risk of heart attack and stroke in these patients,” says Professor Mangoni.

The study used a relatively new statistical technique called latent class analysis to investigate whether specific groups of anti-rheumatics, rather than single agents, have different effects on the endothelium.

The article, Patterns of anti-inflammatory and immunomodulating drug usage and microvascular endothelial function in rheumatoid arthritis (2021) by Arduino A Mangoni, Richard J Woodman, Matteo Piga, Alberto Cauli, Anna L Fedele, Elisa Gremese and Gian Luca Erre, has been published in Frontiers in Cardiovascular Medicine DOI: 10.3389/fcvm.2021.681327

© Scoop Media

Culture Headlines | Health Headlines | Education Headlines


Howard Davis: Emerald Fennell's Promising Young Woman'

The Guardian needed not one, but three reviews to do justice to Fennell's unsettling approach, which indicates exactly how ambiguous and controversial its message really is. More>>

Howard Davis: Jill Trevelyan's Rita Angus

Although Angus has become one of Aotearoa’s best-loved painters, the story of her life remained little known and poorly understood before Jill Trevelyan's acclaimed and revelatory biography, which won the Non Fiction Award at the Montana New Zealand Book Awards in 2009, and has now been republished by Te Papa press. More>>

Howard Davis: The Back of the Painting

Painting conservators are the forensic pathologists of the art world. While they cannot bring their subjects back to life, they do provide fascinating insights into the precise circumstances of a painting's creation, its material authenticity, and constructive methodology. More>>

Howard Davis: Black Panthers on the Prowl

A passionate and gripping political drama from Shaka King, this is an informative and instructive tale of human frailty that centers around the charismatic Chicago Black Panther leader Fred Hampton, who was murdered at the age of twenty-one during a police raid. More>>

Howard Davis: Controlling the High Ground

Stephen Johnson's raw and angry film not only poses important questions with scrupulous authenticity, but also provides a timely reminder of the genocidal consequences of casual bigotry and xenophobia. More>>

Howard Davis: Dryzabone - Robert Conolly's The Dry

After the terrible devastation caused by last year’s bushfires, which prompted hundreds of Australians to shelter in the ocean to escape incineration and destroyed uncountable amounts of wildlife, The Dry has been released during a totally different kind of dry spell. More>>

Howard Davis: Hit the Road, Jack - Chloé Zhao's Nomadland

Nomadland is perhaps the ultimately 'road' movie as it follows a group of dispossessed and disenfranchised vagabonds who find a form of communal refuge in camp sites and trailer parks after the economic contraction of 2008. More>>



  • Wellington
  • Christchurch
  • Auckland