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Cardiovascular Safety of Biologics and JAK Inhibitors in Patients with Rheumatoid Arthritis

  • Rheumatoid Arthritis (L Moreland, Section Editor)
  • Published:
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Abstract

Purpose of Review

Increased cardiovascular (CV) risk and associated mortality in rheumatoid arthritis (RA) are not fully explained by traditional CV risk factors. This review discusses the epidemiology and mechanisms of increased CV risk in RA and treatment effects on CV risk focusing on biologic disease-modifying anti-rheumatic drugs (DMARDs) and JAK inhibitors.

Recent Findings

Intermediary metabolic changes by inflammatory cytokines are observed in body composition, lipid profile, and insulin sensitivity of RA patients, leading to accelerated atherosclerosis and increased CV risk. Successful treatment with DMARDs has shown beneficial effects on these metabolic changes and ultimately CV outcomes, in proportion to the treatment efficacy in general but also with drug-specific mechanisms. Recent data provide further information on comparative CV safety between biologic DMARDs or JAK inhibitors as well as their safety signals for non-atherosclerotic CV events.

Summary

CV benefits or safety signals associated with DMARD treatments can differ despite similar drug efficacy against RA, suggesting that both anti-inflammatory and drug-specific mechanisms are involved in altering CV risk.

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Authors and Affiliations

  1. Division of Rheumatology Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea

    Eun Ha Kang

  2. Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Katherine P. Liao & Seoyoung C. Kim

  3. Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA, 02120, USA

    Seoyoung C. Kim

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  1. Eun Ha Kang
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SCK has received research support to the Brigham and Women’s Hospital from Roche, Pfizer, and Bristol-Myers Squibb.

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This article is part of the Topical Collection on Rheumatoid Arthritis

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Kang, E.H., Liao, K.P. & Kim, S.C. Cardiovascular Safety of Biologics and JAK Inhibitors in Patients with Rheumatoid Arthritis. Curr Rheumatol Rep 20, 42 (2018). https://doi.org/10.1007/s11926-018-0752-2

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