RESEARCH - TNF antagonist use associated with reduced risk of cardiovascular events in RA

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Ann Rheum Dis 2011;70:576-582 doi:10.1136/ard.2010.129916

Clinical and epidemiological research

Extended report

Tumour necrosis factor antagonist use and associated risk reduction of

cardiovascular events among patients with rheumatoid arthritis

D Greenberg1, M Kremer2, R Curtis3, Marc C

Hochberg4, 5, Tsao6, E Farkouh7, Adeel

Nasir1, Soko Setoguchi8, H 8 on behalf of the CORRONA

Investigators

+ Author Affiliations

1Department of Rheumatology, New York University Hospital for Joint

Diseases, New York, New York, USA

2Division of Rheumatology, Albany Medical College, Albany, New York, USA

3Division of Clinical Immunology and Rheumatology, University of

Alabama at Birmingham, Birmingham, Alabama, USA

4Division of Rheumatology and Clinical Immunology, University of

land, Baltimore, land, USA

5Division of Preventive and Behavioral Medicine, University of

Massachusetts School of Medicine, Worcester, Massachusetts, USA

6Division of Rheumatology, Immunology, and Allergy, Brigham and

Women's Hospital, Boston, Massachusetts, USA

7Clinical Trials Unit, Mount Sinai Heart, New York, New York, USA

8Division of Pharmacoepidemiology, Brigham and Women's Hospital,

Boston, Massachusetts, USA

Abstract

Objective To examine the association of cardiovascular events with

tumour necrosis factor (TNF) α antagonist use compared with

non-biological disease-modifying antirheumatic drug (DMARD)

utilisation in patients with rheumatoid arthritis (RA).

Methods The study population included 10 156 patients enrolled in the

Consortium of Rheumatology Researchers of North America RA registry.

Three study cohorts were defined based on three mutually exclusive

drug use categories, including TNF antagonists, methotrexate and other

non-biological DMARDs. HR were calculated adjusting for cardiovascular

risk factors, RA disease characteristics and prednisone use. The

primary study outcome was a composite of non-fatal myocardial

infarction (MI), transient ischaemic attack (TIA) or stroke and

cardiovascular-related death.

Results There were 88 cardiovascular events, including 26 MI, 45

TIA/strokes and 17 cardiovascular-related deaths. After adjusting for

age, gender, cardiovascular risk factors and RA disease

characteristics, patients using a TNF antagonist experienced a reduced

risk of the primary composite cardiovascular endpoint (HR 0.39, 95% CI

0.19 to 0.82) compared with users of non-biological DMARDs.

Methotrexate was not associated with a reduced risk (HR 0.94, 95% CI

0.49 to 1.80). Prednisone use was associated with a dose-dependent

increased risk (p=0.04). The risk reduction associated with TNF

antagonists was also observed for non-fatal cardiovascular events (HR

0.35, 95% CI 0.16 to 0.74).

Conclusion TNF antagonist use was associated with a reduced risk of

cardiovascular events in patients with RA.

http://ard.bmj.com/content/70/4/576.abstract

Not an MD

[Guest guest]

This is good news for those of us on Enbrel, Humira, and Remicade, a

little silver lining to the dark cloud of RA.

Sue

On Mar 21, 2011, at 9:01 PM, wrote:

> Conclusion TNF antagonist use was associated with a reduced risk of

> cardiovascular events in patients with RA.