A recent study has shown that using a combination of a tumor necrosis factor (TNF), together with methotrexate in people with rheumatoid arthritis (RA) was associated with a reduced risk of heart attack by 80 percent compared to patients using methotrexate alone, according to research presented recently at the American College of Rheumatology Annual Scientific Meeting in Boston, Massachusetts. Rheumatoid arthritis is a chronic
, systemic diseases, autoimmune not only causes pain, stiffness, swelling, and limitation of function in the joints, but also damage internal organs as well.
Approximately 2.1 million Americans are affected by RA, most of them women. As mentioned above, while the joints are the principal areas affected by RA, inflammation can develop in other organs as well. Heart attacks, resulting in inflammation of the coronary vessels, are more common in RA patients.
Researchers recently studied the risk of heart attack in patients receiving a TNF inhibitor (a drug that blocks the cytokine and can stop the chronic inflammation that causes destruction in RA), methotrexate (a drug used to treat RA by blocking metabolism of cells) and other disease modifying anti-rheumatic drugs (DMARDs), which are a class of drugs used to slow disease progression in RA, in a population of patients with RAmany of which were also taken aspirin.
Information obtained from Medical, Medicaid program California, researchers studied patients aged over 18 who suffer from RA who were treated with TNF inhibitors, methotrexate or other DMARDs over a period of six years half. They were identified
A total of 19 233 patients with RA. The mean age of patients was 55 years. "
Approximately 79 percent were women. Of these patients, 13,383 were taking methotrexate; 14958 had other DMARDs, and 4943 took TNF inhibitors. The exposure of a group of patients TNF-inhibitors (given alone or in combination with methotrexate) was compared with that of another group that methotrexate alone.
During the study period, 441 patients suffered heart attacks, of which eight percent were fatal.
Researchers found that patients on the combination of TNF inhibitor therapy methotrexate had a risk of heart attack only 20 percent risk compared to patients taking methotrexate alone.
However, there was no difference statistically observed among patients who were taking TNF inhibitors alone, TNF-inhibitors with other DMARDs, other DMARD therapy without methotrexate, or a combination of DMARDs and methotrexate. Therefore, this reduction in cardiovascular events appears to be a function of the combination of methotrexate and TNF-inhibitors.
TNF-inhibitor, in combination with methotrexate, dramatically reduce risk of heart attack in patients with RA and should be considered seriously especially in high-risk patients, "said Gurkirpal Singh, MD, professor of medicine clinic in the Division of Gastroenterology at the Stanford University School of Medicine and an investigator in the study.
Notion that RA is a disorder potentially crippling is widely accepted. However, what generally not known is that it is a potentially fatal disease that leads to an increased risk of heart attack and stroke.
Is imperative that patients with RA understand the systemic nature of this condition and the need for aggressive intervention. This study gives more ammunition to argue that RA patients should be treated with a combination of methotrexate and biologic therapy not only reduces the chances of crippling deformity but also to reduce the risk of cardiovascular death.
Category: Healthcare Basics