Reduced Cardiovascular Risk with Use of Methotrexate and Tumor Necrosis Factor Alpha Inhibitors in Patients with Rheumatoid Arthritis

Another abstract from the 2011 ACR meeting at Chicago that has been discussed at this weekend’s TNF alpha Forum at Munich addressed the question of cardiovascular risk. And here is this abstract, too.


Rasa Bozaite-Gluosniene and colleagues examined the independent contribution of methotrexate and tumor necrosis factor alpha inhibitors on the incidence of coronary artery disease in rheumatoid arthritis patients (inception cohort of 1829 patients without preexisting coronary artery disease). The incidence rate for coronary artery disease dropped from 37.5 to 17.6 events per 1000 person-years (methotrexate non users to methotrexate users). As for TNF-alpha inhibitors nonusers and users the incidence rate for coronary artery disease dropped from 32.1 to 11.8 events per 1000 person-years. Using methotrexate and tumor necrosis factor alpha inhibitors for longer than 24 months was associated with a further reduction of the incidence of coronary artery disease. The authors saw a possibility for tumor necrosis factor alpha inhibitor use offering an additional cardioprotective effect in rheumatoid arthritis patients.


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Reduced Cardiovascular Risk with Use of Methotrexate and Tumor Necrosis Factor-alpha Inhibitors in Patients with Rheumatoid Arthritis.
Rasa Bozaite-Gluosniene1, Xiaoqin Tang2, H. Lester Kirchner2, Jana L. Antohe3, Stephanie J. Morris4, Mary Chester Wasko5 and Androniki Bili1.
1Geisinger Medical Center, Danville, PA, 2Geisinger Center for Health Research, Danville, PA, 3Geisinger Health System, Danville, PA, 4Rose Tree Medical Associates---Riddle Memorial Hos, Danville, PA, 5West Penn Allegheny Health System, Pittsburgh, PA
Conclusion: In this inception RA cohort, the use of MTX or TNF-alpha inhibitors was independently associated with a 46% reduction in incident CAD compared to nonusers; for MTX or TNF-alpha inhibitor use for more than 24 months the risk was further decreased by 67% and 76% respectively, raising the possibility that TNF-alpha inhibitor use offers additional cardioprotective effect in RA patients.