RESEARCH - RA severity linked to stroke

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Rheumatoid Arthritis Severity Linked to Stroke

NEW YORK (Reuters Health) Sept 08 - Rheumatoid arthritis is a risk

factor for stroke and the greater its severity, the higher the risk,

new research indicates. The findings also suggest that drugs used to

treat rheumatoid arthritis are not linked to stroke, with the

exception of rofecoxib.

" This study contributes new information regarding pharmacologic and

nonpharmacologic risk factors for stroke in rheumatoid arthritis, "

senior author Dr. Frederick Wolfe and colleagues note. " In addition,

we provide another estimate of the risk of rheumatoid arthritis on

subsequent stroke using a patient population where clinical

information was available, complementing the administrative database

estimates already available. "

The study, reported in the August 15th issue of Arthritis and

Rheumatism, involved a case-control analysis of 269 rheumatoid

arthritis patients with a first-ever stroke who were matched by age,

gender, and time of cohort entry with up to 20 controls.

Overall, rheumatoid arthritis increased the risks of any stroke and

ischemic stroke by 1.64- and 2.66-fold, respectively, Dr. Wolfe, from

the National Data Bank for Rheumatic Diseases in Wichita, Kansas, and

associates report. As noted, the risk of stroke was directly related

to rheumatoid arthritis severity.

Other risk factors for ischemic stroke included MI, hypertension,

low-dose aspirin, total joint replacement, Health Assessment

Questionnaire score, and comorbidity score. By contrast, smoking,

exercise, body mass index, and diabetes did not affect the risk.

Rofecoxib was the only drug significantly linked to stroke, increasing

the odds by 2.27-fold. There was, however, a suggestion that

corticosteroids may raise the risk as well.

The apparent non-effect of diabetes on stroke in this population as

well as the risks of steroid use are among the topics that require

further investigation, the researchers conclude.

Arthritis Rheum 2008;59:1090-1096.

http://www.medscape.com/viewarticle/580193

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Not an MD