Lower CVD Risk With Stable DMARD Therapy in Seropositive Rheumatoid Arthritis
METHODOLOGY:
- The risk for CVD in patients with RA is closely associated with increasing levels of systemic inflammation; however, the risk for CVD in those with RA who are on stable DMARD therapy is still unknown.
- Researchers assessed the risk for CVD in patients identified from the Norwegian Cardio-Rheuma Register who had at least two seropositive RA diagnosis codes and at least one DMARD prescription.
- They classified patients into two groups: The stable treatment group, comprising patients who retained their initial DMARD throughout follow-up and had no corticosteroid prescriptions beyond the initial 6 months after diagnosis (n = 657; median age, 57 years; 64.2% women), and the nonstable treatment group, comprising the remaining patients (n = 7871; median age, 59 years; 68.8% women).
- All patients were matched 1:10 to control individuals from the general population for birth year and sex.
- The outcome was a five-point major adverse cardiovascular event (5p-MACE), which included acute myocardial infarction, stroke, death due to CVD, and hospitalization for unstable angina or heart failure, with follow-up until the date of outcome, death, or end of the study period, whichever occurred first.
TAKEAWAY:
- The stable treatment and control groups had comparable baseline CVD and associated risk factors (except for diabetes), unlike the nonstable treatment group that had a higher prevalence of established CVD and associated risk factors.
- The risk for 5p-MACE was lower in the stable treatment group than in the nonstable treatment group (adjusted hazard ratio [HR], 0.58; P = .039).
- Moreover, patients in the nonstable treatment group had a higher likelihood of experiencing 5p-MACE than control individuals (HR, 1.39; P < .001).
https://www.medscape.com/viewarticle/lower-cvd-risk-stable-dmard-therapy-seropositive-rheumatoid-2024a10008g8