Risk factor for biologics: cardiovascular events in rheumatism patients

Rheumatism patients who are treated with biologics have an increased risk of cardiovascular events. That in itself is nothing new. But a new study shows how high the risk really is.

Biologics, rheumatoid arthritis and heart disease

Large Scandinavian study had over 24,000 participants.
Underlying disease was rheumatoid arthritis (RA).
Treatment with biologics resulted in an 80% higher risk of a cardiovascular event than in the general population.
Which biologic is taken was largely irrelevant.

Rheumatoid diseases are on the rise

Many people who suffer from RA or other autoimmune diseases from the rheumatological spectrum also have heart conditions. And not only that. If they are treated with biologics, or bDMARDs (biologic disease-modifying antirheumatic drugs), the risk of cardiovascular disease and events increases significantly.

The heart is clearly at risk under biologics therapy

Many RA patients benefit from taking bDMARDs. However, these drugs are not without side effects. A recent study from Scandinavia investigated the incidence of acute coronary syndromes and other cardiovascular diseases under biologics therapy.

The result - probably surprising for many - is that RA patients taking biologics have an almost 80% higher risk of acute cardiac events than the general population. The analysis is based on a large cohort of over 24,000 people and a follow-up period of five years.

No great variation across different drugs

The study authors also looked into the question of whether different bDMARDs are associated with different risks for cardiovascular events. The answer here is: no. It made no difference in the study which biologic the patient was taking.

Conclusion for medical practice

The data once again illustrate the importance of cardiological co-treatment of patients with rheumatic diseases. In particular, the high risk of acute cardiac events should be taken into account and appropriate preventive measures should be taken.

Source:

Delcoigne B, Ljung L, Provan SA, Glintborg B, Hetland ML, Grøn KL, Peltomaa R, Relas H, Turesson C, Gudbjornsson B, Michelsen B, Askling J. Short-term, intermediate-term and long-term risks of acute coronary syndrome in cohorts of patients with RA starting biologic DMARDs: results from four Nordic countries. Ann Rheum Dis. 2022 Jun;81(6):789-797. doi: 10.1136/annrheumdis-2021-221996. Epub 2022 Mar 22. PMID: 35318218; PMCID: PMC9120408.