Effect of Anti-Rheumatic Drugs on Cardiovascular Disease Events in Rheumatoid Arthritis

Abstract

Rheumatoid arthritis (RA) is an autoimmune disease characterized by erosive arthritis, which can involve multiple systems. Patients with RA may have a variety of comorbidities, including cardiovascular disease (CVD), lung cancer, lymphoma, infection, osteoporosis, fatigue, depression, colon cancer, breast cancer, prostate cancer, and Alzheimer's disease. Among these comorbidities, the incidence of CVD, lung cancer, lymphoma, infection, and osteoporosis is higher. CVD is a serious complication of RA. The risk of CVD and associated mortality rate in patients with RA is high, and the treatment rate is low. In addition to traditional risk factors, such as age, sex, blood pressure, and diabetes, RA is also associated with inflammation. Furthermore, therapeutic drugs for RA, including non-steroidal anti-inflammatory drugs, glucocorticoids, and disease-modifying anti-rheumatic drugs, have beneficial or harmful effects on cardiovascular events in patients with RA. This article discusses the effects of therapeutic drugs for RA on cardiovascular events.

A comprehensive review of Tripterygium wilfordii hook. f. in the treatment of rheumatic and autoimmune diseases: Bioactive compounds, mechanisms of action, and future directions

“…With respect to the treatment of RA, T. wilfordii glycosides have been demonstrated to inhibit the release of chemotactic factors from macrophages, thereby reducing their effects on synovial cells and chondrocytes, and thus inhibiting the abnormal proliferation of synovial cells (Baoqi et al, 2021). Furthermore, treatment with LLDT-8 has been found to suppress matrix metalloproteinase-13 production via the OPG/RANK/RANKL signaling pathway, increase OPG/RANKL expression, and attenuate collageninduced arthritis (Shen et al, 2015).…”

Methotrexate and cardiovascular prevention: an appraisal of the current evidence

“…Importantly, current evidence suggests that other immunomodulatory and anti-inflammatory agents do not share the putative protective effects of methotrexate against atherosclerosis and cardiovascular disease. 136 , 137 In a systematic review and meta-analysis of eight studies investigating a total of 65,736 patients with rheumatoid arthritis, methotrexate use was associated with a significant reduction in total cardiovascular events when compared to other csDMARDs (RR = 0.72, 95% CI: 0.57–0.91, p = 0.007). A substantial reduction in the specific risk of myocardial infarction was also observed in a subgroup of three studies (RR = 0.81, 95% CI: 0.68–0.96).…”

Anemoside B4 alleviates arthritis pain via suppressing ferroptosis‐mediated inflammation

“…Chronic pain is the key manifestations of RA, which impairs patients' physical function 2 . Nonsteroidal anti‐inflammatory drugs, disease‐modifying antirheumatic drugs and glucocorticoids are used to treat pain of RA 3 . Research on the mechanisms of RA pain is helpful for therapy of pain management.…”

“…2 Nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs and glucocorticoids are used to treat pain of RA. 3 Research on the mechanisms of RA pain is helpful for therapy of pain management.Central sensitization, the key mechanism of chronic pain, plays a pivotal role in RA pain. 4 According to the central sensitization inventory, about 41% of RA patients have central sensitization…”