Tumour necrosis factor antagonist use and associated risk reduction of cardiovascular events among patients with rheumatoid arthritis
Open accessAbstract
Objective To examine the association of cardiovascular events with tumour necrosis factor (TNF) α antagonist use compared with non-biological disease-modifying antirheumatic drug (DMARD) utilisation in patients with rheumatoid arthritis (RA).Methods The study population included 10 156 patients enrolled in the Consortium of Rheumatology Researchers of North America RA registry. Three study cohorts were defined based on three mutually exclusive drug use categories, including TNF antagonists, methotrexate and other non-biological DMARDs. HR were calculated adjusting for cardiovascular risk factors, RA disease characteristics and prednisone use. The primary study outcome was a composite of non-fatal myocardial infarction (MI), transient ischaemic attack (TIA) or stroke and cardiovascular-related death.Results There were 88 cardiovascular events, including 26 MI, 45 TIA/strokes and 17 cardiovascular-related deaths. After adjusting for age, gender, cardiovascular risk factors and RA disease characteristics, patients using a TNF antagonist experienced a reduced risk of the primary composite cardiovascular endpoint (HR 0.39, 95% CI 0.19 to 0.82) compared with users of non-biological DMARDs. Methotrexate was not associated with a reduced risk (HR 0.94, 95% CI 0.49 to 1.80). Prednisone use was associated with a dose-dependent increased risk (p=0.04). The risk reduction associated with TNF antagonists was also observed for non-fatal cardiovascular events (HR 0.35, 95% CI 0.16 to 0.74).Conclusion TNF antagonist use was associated with a reduced risk of cardiovascular events in patients with RA.
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Treatment with TNF inhibitors in rheumatoid arthritis is associated with a decreased risk of cardiovascular events.
“treatment with TNF inhibitors in rheumatoid arthritis, an overt inflammatory disease, is associated with a decreased risk of cardiovascular events”
From Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty (2018) · cites this paper as [183]
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- Authors
- Greenberg, J. D., Kremer, J. M., Curtis, J. R., Hochberg, M. C., Reed, G., Tsao, P., Farkouh, M. E., Nasir, A., Setoguchi, S., & Solomon, D. H.
- Affiliations
- New York University Langone Orthopedic Hospital (US)
- Albany Medical College (US)
- University of Alabama at Birmingham (US)
- University of Maryland, Baltimore (US)
- University of Massachusetts Chan Medical School (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Greenberg, Jeffrey D
- ORCID
- Venue
- Annals of the Rheumatic Diseases
- Publisher
- Elsevier BV
- Published
- 2011-04
- Volume
- 70
- Issue
- 4
- Pages
- 576-582
- ISSN
- 0003-4967 (ISSN-L)
- OpenAlex
- W2096809109
- Cited by
- 350
- References
- 39
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 10 · 2023: 13 · 2022: 14 · 2021: 17 · 2020: 21 · 2019: 16 · 2018: 17 · 2017: 28 · 2016: 33 · 2015: 26 · 2014: 30 · 2013: 46 · 2012: 43
- FWCI
- 24.31
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Annals of the Rheumatic Diseases (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Arthritis Foundation
- Amgen
- Eli Lilly and Company
- Agency for Healthcare Research and Quality (R01HS018517)
- Genentech
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (AR 047782, AR053351, K24AR055989, K23AR053351, P60AR047782, AR 055989, K23AR054412)
- Topics
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Health Sciences › Medicine › Pharmacology › Inflammatory mediators and NSAID effects
- Health Sciences › Medicine › Hematology › Autoimmune and Inflammatory Disorders Research
- Keywords
- rheumatoid arthritis, tumor necrosis factor inhibitors, cardiovascular events, myocardial infarction, stroke, transient ischemic attack, methotrexate, prednisone, cardiovascular risk
- MeSH terms
- Adult, Aged, Arthritis, Rheumatoid, Cardiovascular Diseases, Epidemiologic Methods, Female, Humans, Immunologic Factors, Male, Middle Aged, Tumor Necrosis Factor-alpha, United States, Antirheumatic Agents
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