VIDEO: How comorbidities impact RA treatment

Editor’s note: This is a previously posted video, and the below is an automatically generated transcript to be used for informational purposes. Please notify cperla@healio.com if there are concerns regarding accuracy of the transcription.

So it certainly impacted the ORAL surveillance study with JAK inhibitors because we know that malignancies and cardiovascular events MACEs were increased with tofacitinib, and that there seemed to be the similar increase in patients from North America who were present or past smokers. So of course we've been worried about cardiovascular disease, malignancies and serious infections in RA for a long time, and that's led to different labeling and black box warnings with therapies for RA.

And it's interesting that most of them have a black box warning whereas a couple still don't. But the other interesting thing about RA is the lipid paradox where we're suddenly seeing that some of those patients who have very low LDLs don't necessarily have high HDLs they're at increased risk.

And even though they may not be obese or have what we consider to be the usual obvious things that we worry about. So I think it's become more interesting for us to look at this, and of course we've been worried about things like the JAK inhibitors and the IL six receptor inhibitors affecting lipid levels but it may be that we haven't understood this as well as we should have but it may be that it's not just the drug effect.