RESEARCH - Vasculitis in RA

[Guest guest]

Curr Opin Rheumatol. 2009 Jan;21(1):35-40.

Vasculitis in rheumatoid arthritis.

Turesson C, Matteson EL.

Department of Rheumatology, Malmo University Hospital, Malmo, Sweden.

PURPOSE OF REVIEW: To examine the occurrence and pathophysiology of

vasculitis in rheumatoid arthritis (RA), describe the epidemiology and

clinical features, and provide a therapeutic perspective.

RECENT FINDINGS: With improved control of RA over the past two

decades, the risk of severe outcomes such as vasculitis may be

decreasing. Rheumatoid vasculitis continues to be associated with

longstanding, erosive, seropositive disease, and it has recently been

shown to be more frequent among patients with antibodies to cyclic

citrullinated peptides. Apart from circulating immune complexes,

expansion of cytotoxic CD28null T cells and circulating

proinflammatory cytokines also play a role in the pathogenesis. The

role of agents directed against the tumor necrosis factor (TNF) in the

occurrence and management of rheumatoid vasculitis remains unclear, as

rheumatoid vasculitis may be both associated with and treated with

anti-TNF agents, once it has appeared.

SUMMARY: Vasculitis in RA is generally associated with longstanding

disease, has an important impact on a patient's well being, and

markedly influences patient life expectancy. Advances in therapies for

RA will likely continue to reduce the incidence of vasculitis, and

improved management of cardiovascular comorbidity in patients with RA

will be of particular benefit to those who suffer from vasculitis and

other extraarticular manifestations.

PMID: 19077716

http://www.ncbi.nlm.nih.gov/pubmed/19077716

Not an MD