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Rheumatoid Arthritis Drugs May Boost Cardiovascular Risk

Glucocorticoids, cytotoxic drugs increase risk by 30 to 80 percent

THURSDAY, Nov. 30 (HealthDay News) -- Biologic immunosuppressive agents do not affect the risk of cardiovascular events in patients with rheumatoid arthritis, but the risk increases by 30 percent to 80 percent in patients taking glucocorticoids or cytotoxic immunosuppressive drugs, according to study findings published in the December issue of Arthritis & Rheumatism.

Daniel H. Solomon, M.D., from Harvard Medical School in Boston, and colleagues identified 3,501 Pennsylvania Medicare beneficiaries with rheumatoid arthritis who were taking immunosuppressive medication. Of these, 946 were hospitalized for a cardiovascular event during the follow-up period, and 10 controls were matched to each case.

Compared with patients taking only methotrexate, the researchers found that biologics alone or in combination with other drugs did not increase the risk of cardiovascular events. In contrast, there was an increased risk with glucocorticoids alone (odds ratio, 1.5) or in combination (OR, 1.3), as well as an increased risk with the cytotoxic immunosuppressive agents azathioprine, cyclosporine and leflunomide alone or in combination (OR, 1.8).

"When compared with rheumatoid arthritis patients receiving methotrexate monotherapy, those receiving biologic immunosuppressive agents had neither an increased nor decreased risk of experiencing a cardiovascular event, whereas use of oral glucocorticoids and cytotoxic immunosuppressive agents was associated with significant increases in the risk of cardiovascular events," Solomon and colleagues conclude.

The study was partially supported by research grants from Merck, Pfizer, and Savient.

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