REVIEW - Vascular effects of biologic agents in RA and spondyloarthropathies

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Nat Rev Rheumatol. 2009 Dec;5(12):677-84. Epub 2009 Nov 10.

Vascular effects of biologic agents in RA and spondyloarthropathies.

Szekanecz Z, Kerekes G, Soltész P.

Department of Rheumatology Institute of Medicine, University of

Debrecen Medical and Health Science Center, Debrecen, Hungary.

Endothelial dysfunction and accelerated atherosclerosis lead to

increased cardiovascular morbidity and mortality in patients with

rheumatoid arthritis and other inflammatory rheumatic diseases.

Sustained inflammation is a major risk factor for cardiovascular

disease. Apart from traditional vasculoprotective agents, biologic

agents may also exert favorable effects on the vasculature. Indeed,

agents that inhibit tumor necrosis factor (TNF) seem to transiently

improve endothelial function. Data regarding the effects of biologic

agents on atherosclerosis and arterial stiffness are inconsistent. The

effects of the various TNF blockers on dyslipidemia might differ:

long-term infliximab therapy could be pro-atherogenic, whereas some

studies suggest that etanercept and adalimumab may exert beneficial

effects on the lipid profile. TNF blockers have been shown to decrease

the incidence of cardiovascular events in patients with rheumatoid

arthritis. Preliminary data suggest that rituximab also improves

endothelial function and dyslipidemia. Further studies are needed to

determine the net effects of biologic agents on the vasculature.

PMID: 19901918

http://www.ncbi.nlm.nih.gov/pubmed/19901918

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