Excess Cardiovascular Risk in RA Patients Has Declined Since 2000, Study Finds

New results from a meta-analysis reveal a decrease in the excess risk of cardiovascular events in patients with rheumatoid arthritis (RA) since the start of the 21st century.

Patients with RA are often associated with having a greater risk of cardiovascular disease, stroke, myocardial infarction (MI), congestive heart failure (CHF), and cardiovascular mortality (CVM) when compared to the general population. However, the results of the new analysis revealed that the risk of cardiovascular events is declining. The findings were presented at the Annual European Congress of Rheumatology in Madrid, Spain, according to a press release.

“This reduction in cardiovascular risk may have two explanations,” said study author Elisabeth Filhol, a rheumatologist in training at Nîmes University Hospital in France, in the statement. "It may simply be due to better management of cardiovascular risk in patients with RA.”

Researchers performed a detailed literature search to measure the changes in cardiovascular risk in this population before and after 2000. The study considered 5714 screened references; however, only 28 studies met the necessary criteria to determine the risks of cardiovascular events.

“However, knowing that systemic inflammation is the cornerstone of both RA and atherosclerosis, it may also be related to better control of chronic systemic inflammation as the result of new therapeutic strategies,” suggested senior investigator Professor Cécile Gaujoux-Viala of the University of Montpellier and head of the rheumatology department at the Nîmes University Hospital.

A meta-analysis was used to determine the relative risk for RA patients compared to a control group both before and after the start of the 21st century. The results for the studies before 2000 confirmed an increased risk for all 4 cardiovascular events in RA patients, while the studies after 2000 did not demonstrate an association between CHF and CVM. There was an increased risk of MI, but it was lower than in the period before 2000.

“Over the past fifteen years, new treatment strategies such as tight control, treat to target, methotrexate optimisation, and the use of biologic DMARDs has allowed a better control of systemic inflammation in patients with RA,” Gaujoux-Viala concluded.