Rheumatoid arthritis treatment with TNF inhibitors can decrease the risk of heart attack

Primary tabs

Rheumatoid arthritis treatment with TNF inhibitors can decrease the risk of heart attack

According to new research at the University of Manchester, heart attack risk associated with rheumatoid arthritis (RA) may be reduced by nearly 40% if treated with tumour necrosis factor (TNF) inhibitors.

Patients with RA have a 60% higher risk of heart attacks as compared to their healthy peers. The higher risk is believed to be associated with the inflammation. Biologic drugs such as TNF inhibitors (TNFi) reduces inflammation by decreasing the activity of inflammatory proteins and synthetic disease-modifying antirheumatic drugs (sDMARDs) such as methotrexate, which delays the disease progression of RA.

In  United Kingdom ., it is allowed to prescribe TNFi drugs to highly active RA patients for whom treatment with sDMARDS was inefficient. However, the patients with chronic inflammation at moderate levels of the disease are not eligible for this treatment. Researchers from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis (BSRBR-RA) at the Arthritis Research UK Centre for Epidemiology at The University of Manchester, studied two groups of RA patients to determine both heart attack risk and the severity of the attack.

The research included 11,200 RA patients on TNFi medication and 3,058 patients on sDMARDs and analyzed data from their clinical follow-up recorder over 3 to 5 years to investigate the risk of heart attack and its severity.

Kimme Hyrich, a Professor in The University of Manchester’s Division of Musculoskeletal & Dermatological Sciences, led the BSRBR-RA’s research said, “RA patients already have to endure a debilitating condition, but to have an elevated risk of heart attacks because of their disease is a very worrying complication. In addition to managing risk factors such as high blood pressure and high cholesterol, achieving excellent control of inflammation can also reduce this risk. Our team has been able to show that this elevated risk can be reduced significantly by using biological drug therapies such as TNFi. The prescribing guidelines for TNFi therapies are very specific and for a good reason. “However, the biologically plausible explanation for our findings – not only that TNFi reduces the inflammation associated with atherosclerosis but that it also may inhibit the accumulation and progression of plaque leading to fewer heart attacks – could be used to review existing guidelines and in particular, extend the use to patients with moderate levels of disease activity”.

Another research linked the national registry of patients with RA with the national registry of health attack and revealed a striking relationship between the use of biological treatments for RA and reduced risk of heart attack.

Further research is needed to investigate the cellular mechanisms behind this and also to test whether immunosuppressive agents may reduce the risk of heart attack in other high-risk populations.

Stephen Simpson, Director of Research and Programmes at Arthritis Research UK, said, “this promising research could make a real difference to people with arthritis who live with the knowledge that they are having an increased risk of heart attack. We are delighted that our funding is helpful in finding the ways to understand, reduce that risk and help the people to give everyday freedom they need from the limits of arthritis”.

Heart attacks severity, another research outcome related occurred in the total study cohort and found no difference in the severity of heart attacks among those who did suffered from myocardial infarction while on either drug therapy. So, while TNFi treatments reduced the risk of heart attack, it showed no impact on the severity of heart attacks among RA patients.

This research will help guide the future work in probing out new ways to reduce the heart attack in people living with RA. In the meantime, it is important that patients with RA should not only be offered treatment for their condition, but also the management to reduce the risk of a heart attack.


University of Manchester

Link to the source:


The original title of the article:

Risk of heart attack in rheumatoid arthritis patients almost halved by biologic drugs


Kimme Hyrich, Dr Chris Gale


Therapeutic, Rheumatoid Arthritis, Heart Attack, Joints, Heart, TNF Inhibitors, Efficacy
Log in or register to post comments