Reduced cardiovascular risk linked with immunotherapy for patients with RA

A decrease in cardiovascular events was observed in patients with rheumatoid arthritis treated with immunotherapy, according to research presented at Frontiers in CardioVascular Biology 2016.

According to a press release from the European Society of Cardiology, investigators also found patients who took a combination of two extra-low dose anticytokine drugs, anti-tumor necrosis factor-alpha (TNF-α) and anti-interferon (IFNƔ), showed signs of reduced rheumatoid arthritis (RA) disease activity and cardiovascular events.

Aida Babaeva, head of the Department of Internal Medicine at Volgograd State Medical University in Volgograd, Russia and colleagues performed a randomized, placebo-controlled study to evaluate how the combination of drugs influence cardiovascular events. Researchers enrolled 68 patients who had active RA for at least 5 years in the study. Thirty-eight patients were selected to receive the combination of anti-TNF-α and anti-IFNƔ plus standard disease-modifying therapy, while 30 patients received a placebo plus standard therapy. Participants were followed and monitored for RA disease activity and cardiovascular events for 3 years.

Investigators found DAS28 results showed patients who received the combination of anti-TNFα and anti-IFNƔ had a lower RA disease activity score. In addition, those patients showed significant decreases in interleukin (IL)-1, IL-6 and TNF-α compared to the control group.

In relation to patients who took the combination of anti-TNFα and anti-IFNƔ, the group that took only conventional disease-modifying drugs had more than double the risk of developing cardiovascular events (13% vs. 37%, respectively).

“Our findings suggest that the decreased rheumatoid arthritis disease activity with the combination of anticytokines translates into decreased cardiovascular risk,” Babaeva said in the press release. “Rheumatoid arthritis promotes the development of cardiovascular disease in a number of ways. Therefore, decreasing disease activity may also reduce cardiovascular risk by slowing down or halting these processes.”

Target blood pressure was attained in 71% of patients with hypertension in the combination of anticytokines group. In contrast, 32% of patients in the placebo group reached target blood pressure.

According to Babaeva, “This doesn't mean that the two drugs directly impact on blood pressure. But the combination can improve endothelial function and it could be that blood pressure is more stable when disease activity is low.”

She added, “We found that the combination of two anticytokines containing extra-low doses of antibodies against TNFα and IFNƔ can improve the efficacy of standard rheumatoid arthritis therapy and decrease cardiovascular risk.”

“We do not think that all patients with rheumatoid arthritis should be treated with this combination,” Babaeva concluded. “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.”

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