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02.49 Does biological therapy play any role on cardiovascular risk in rheumatoid arthritis?
  1. Raquel Hernández1,
  2. Julia Uceda1,
  3. Carmen Almeida2,
  4. Jose L. Marenco1
  1. 1Department of Rheumatology, Valme Hospital, Sevilla, Spain
  2. 2Department of Bioestadística, Valme Hospital, Sevilla, Spain

Abstract

Background Although there are conflicting data on the subject, it seems that there is a higher incidence of cardiovascular events (CVE) in Rheumatoid Arthritis (RA) compared to population control. Apart from classical cardiovascular risk factors (CV), we must consider the severity of the inflammatory process plays an essential role in accelerated atherosclerosis in this pathology. On the long term security of biological therapies, we find heterogeneous data in different studies and registries. Has observed a decrease in CV risk in RA patients treated with anti-TNF-α agents.

Objectives The main aim was to evaluate the CV risk and prevalence of CVD in RA treated with biological teraphies versus RA treated with classics disease modifying drugs (DMARDs).

Methods Retrospective cohort study over the CV risk and prevalence of cardiovascular events in RA patients treated with biological therapies. We reviewed a cohort of 260 patients diagnosed with RA (ACR 1987). We recorded sociodemographic variables, classics CV risk factors (smoking history, cholesterol levels, hypertension, diabetes mellitus), immunological profile (presence of RF and/or ACPA), treatment (DMARDs or biological therapy) at the time of the study. The CV risk was measured by the estimated SCORE of atherosclerotic cardiovascular mortality risk in 10 years, for specific values of systolic blood pressure and total cholesterol, according to smoking history, gender and age, calibrated to Spain. Also checked all cardiovascular events occurred since the beginning of RA until time of the study.

Results 72% were women, with a current average age of 58.5 years. 48% were receiving biological therapy with or without concomitant DMARDs. Among the classic CV risk factors highlighted: 38% overweight and obesity in 32% of patients, 14% had diabetes mellitus and 39% hypertension; 51% had dyslipidemia and 18% were smokers. Regarding the immune profile had ACPA+61% and 65% FR +. 13% of patients who did not realise biological therapy treatment showed a high Score (5–10) versus 3.7% of patients with biological therapy treatment, this difference was statistically significant. Regarding the prevalence of cardiovascular events we found no difference between groups, 13% and 15% respectively.

Conclusions patients treated with biological therapy have lower cardiovascular risk than patients treated with DMARs. WE dont found differences in the prevalence of CVE between groups. Probably the reduction of inflammation with TB has direct relation with cardiovascular risk reduction in patients with RA.

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