Cardiovascular events on biologicals for RA (and otherwise), lung disease and methotrexate, and a question about diabetes.
Amid the good news about successful and emerging treatments for rheumatoid arthritis were reports about the hazards that accompany long-term survival with the disease. (Click on the abstract numbers to read complete abstracts of the presentations.)
• Autoantibodies associated with RA confer an increased risk of cardiovascular disease. Data from a population-based study of cardiovascular risk factors in people of diverse ethnic groups correlated higher levels of rheumatoid factor and anti-CCP with increased risk of cardiovascular disease--and not just for people who have RA. (Abstract #1664)
• A large-scale study documents the cardiovascular risk associated with biologicals. Ten years' worth of cohort data from nearly 4,000 patients in a Danish national registry of RA patients treated with biologicals, compared with untreated controls, shows nearly a twofold risk of myocardial infarction, along with lower but still increased risks of atrial fibrillation and stroke. (Abstract #1684)
• A new biomarker may predict coronary atherosclerosis risk in RA patients. Researchers from Vanderbilt and Emory have linked atherosclerosis with the gene that encodes osteoprotegerin, a cytokine receptor that is part of the TNF receptor family. (Abstract #2663)
• If diabetes develops in a patient with RA, blame standard risk factors, not inflammation. More insights from medical records: Analysis of patients in a UK medical database finds that diabetes among RA patients is associated with BMI and smoking. However, diabetes risk seems to be disproportionately increased in patients with psoriatic arthritis, even though adiposity and other standard risk factors play an important role. (Abstract #2614)
• Methotrexate is safe, and perhaps safer than you think. Records of 319 US veterans treated with methotrextae for RA, chosen at random from a VA medical database, show that any one of them was likely to experience a non-serious adverse event within 2 years. However, although the rate of interstitial lung disease was very low (a mere 4%), doctors seemed likely to withdraw treatment at the first sign of a respiratory event. (Abstract #2640)
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