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ACR: Rheumatoid Arthritis Activity Tied to Atherosclerosis

Anti-TNFs and statins may reduce atherosclerosis progression; prednisone may promote it

MONDAY, Nov. 8 (HealthDay News) -- Systemic inflammation associated with rheumatoid arthritis (RA) may contribute to the progression of atherosclerosis, with anti-tumor necrosis factor (TNF) agents and statins potentially reducing atherosclerosis progression and glucocorticoids promoting progression, according to research presented at the annual meeting of the American College of Rheumatology, held from Nov. 7 to 11 in Atlanta.

Jon T. Giles, M.D., of John Hopkins University in Baltimore, and colleagues evaluated 158 RA patients who underwent bilateral B-mode ultrasonography of the common and internal carotid arteries at the first and third study visits, which were an average of 3.2 years apart.

After adjustment for demographics, cardiovascular risk factors, and the thickness of the carotid artery walls at baseline, the investigators found that patients who used anti-TNF agents at baseline had a 37 percent lower rate of progression of the thickness of the common carotid artery walls compared to those who did not undergo anti-TNF treatment. The investigators also found that prednisone exposure was the only RA feature tied to progression of atherosclerosis after adjusting for confounding factors. Patients who used statins at baseline had a lower rate of progression. A higher than average number of swollen joints and higher C-reactive protein levels were independently and significantly associated with the incidence of plaque.

"There seem to be some medications used in RA that can either be protective or can promote atherosclerosis," Giles said in a statement. "Prednisone may be more associated with progression of atherosclerosis in some vascular beds, but medications like TNF inhibitors and statins that are taken to lower cholesterol may limit atherosclerosis in these patients."

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