Disease modifying anti-rheumatic drugs can improve myocardial inflammation in rheumatoid arthritis patients

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Disease modifying anti-rheumatic drugs can improve myocardial inflammation in rheumatoid arthritis patients

Patients suffering from rheumatoid arthritis (RA) are at greater risk of cardiac faliure. The primary factor involved in increasing risk of cardiovascular disease in this particular population is chronic myocarditis. According to the latest research presented at the annual meeting in washington, there is a strong association of cardiovascular inflammation and RA and much improvement has been noted with the use of disease modifying agents.

Rheumatoid arthritis primarily affects joints causing inflamation, stiffness, pain and restricted movement,  but it can also affect other parts of the body. Although anyone can get RA, womans are likely to be at higher risk than men. For the first  time, a team of researchers at Columbia university in new york examined the existence of cardiac inflammation in RA patients without known cardiovascular deformities.

According to the Isabelle Amigues, MD, a rheumatology fellow at Columbia University Department of Medicine and a lead author of the study, there has been a vast modification in the treatment strategies with the use of disease modifying anti-rheeumatic drugs (DMARDs). However, the prevalence of cardiovascular disease and heart faliure is continously increasing in RA patients. He also said that biopsying the heart to rule out the inflammation was quite painful and expensive, but now they have cardiac 18F-fluorodeoxyglucose positron emission-computed tomography (18-F-FDG-PET-CT) that can detect inflammation in the myocardium.

The current study assessed 118 patients with no known CVD events . These participants were ndertaken through 3-D echocardiography to evaluate left ventricular (LV) mass, volumes, and systolic and diastolic function. `At the end of the study, median the maximal standardized uptake value (SUVmax) was 12 percent higher in the RA patients compared to the controls. Higher BMI, and moderate-to-severe disease activity were positively associated with SUVmax in the RA patients. The mean SUVmax was 30 percent higher for the patients with moderate-to-severe disease activity compared with those who had low disease activity. Treatment with a non-TNF inhibitors biologic drug was associated with a 35 percent lower mean SUVmax as compared to RA patients either not on a biologic or on a TNF inhibitors. The correlation of myocardial inflammation with articular inflammation suggests that treatment of joint inflammation could also help improve myocardial inflammation. In a second study, the researchers hypothesized that treatment with DMARDs would improve subclinical myocardial inflammation in RA patients without clinical CVD, who are at higher risk of heart failure.


American College of Rheumatology News

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Original title of article:

Myocardial Inflammation Elevated in RA Patients, But Disease-Modifying Therapy Can Improve It


Jocelyn Givens

American College of Rheumatology News
Therapeutic, Myocardial Inflammation, Rheumatoid arthritis, DMARDs, RCT, Efficacy, DAS28 score
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