Immunotherapy reduces cardiovascular risk in rheumatoid arthritis

http://www.eurekalert.org/pub_releases/2016-07/esoc-irc070516.php

Public Release: 9-Jul-2016
Immunotherapy reduces cardiovascular risk in rheumatoid arthritis
Extra-low dose combination of two anticytokines reduces disease activity and cardiovascular events
European Society of Cardiology

Immunotherapy reduces cardiovascular risk in patients with rheumatoid arthritis, according to research presented today at Frontiers in CardioVascular Biology (FCVB) 2016 by Professor Aida Babaeva, head of the Department of Internal Medicine, Volgograd State Medical University, Volgograd, Russia.1 The combination of two extra-low dose anticytokine drugs reduced rheumatoid arthritis disease activity and cardiovascular events.

"Rheumatoid arthritis is an autoimmune disease in which cytokines such as tumour necrosis factor (TNF) and interferon (IFN), which normally protect the body, attack healthy cells," said Professor Babaeva. "Patients have painful and inflamed joints. They are also at increased cardiovascular risk, particularly if their rheumatoid arthritis is not controlled."

Professor Babaeva's previous research showed that treatment with anticytokine drugs can decrease the activity of rheumatoid arthritis. Extra-low dose anti-TNFα reduced levels of inflammatory mediators and cytokines including C-reactive protein (CRP), rheumatoid factor, TNF, interleukin-1 (IL-1), and interleukin-6 (IL-6). The effect was more apparent and developed earlier when patients were treated with a combination of anti-TNFα and anti-IFN?, both at extra-low doses.

The current study investigated the impact of the combination of drugs on cardiovascular events.

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Patients taking the combination of anticytokines had a lower rheumatoid arthritis disease activity score, as measured by the DAS28,2 and more dramatic decreases in IL-1, IL-6 and TNFα than the group on standard therapy alone.

The incidence of cardiovascular events (unstable angina, severe hypertensive crisis, and deterioration of chronic heart failure) was more than double in the group on conventional disease-modifying drugs alone (37%) compared to those also taking the combination of anticytokines (13%).

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She concluded: "We do not think that all patients with rheumatoid arthritis should be treated with this combination. In patients with highly active disease, the standard biologics are better at preventing severe complications such as progressive joint destruction and/or systemic manifestations (vasculitis, uveitis, involvement of internal organs). We recommend this new approach for preventing cardiovascular events in patients with moderate disease activity who are not receiving the standard biologics and who do not have severe complications."