Arthritis drug may improve early stages of heart disease

Drugs used to treat initial signs of rheumatoid arthritis (RA) can also improve the early stages of heart disease, according to a new study.

Having rheumatoid arthritis (RA) is known to at least double the chances of developing cardiovascular disease (CVD) because of links to atherosclerosis (a build-up of plaque inside the arteries), heart failure and strokes.

The study, published in the journal Annals of the Rheumatic Diseases, linked treatment of RA with improvements in vascular stiffness – an indicator of CVD.

“Our research shows that even at the earliest stages of rheumatoid arthritis, there is increased vascular stiffness in people with no or minimal traditional CVD risk factors such as hypertension, high cholesterol or smoking,” said study author Sven Plein from the University of Leeds in the UK.

For the study, the research team had set out to explore possible connections between the very earliest signs of RA and indicators of CVD. Detailed MRI heart scans were given to 82 patients with no known heart issues.

The scans revealed the presence of increased vascular stiffness in the aorta, which is a gradual loss of elasticity in the large arteries, compared to healthy people.There was also evidence of cardiac scarring and changes in the wall of the left ventricle (the heart’s main pumping chamber), suggesting heart abnormalities had started before the RA diagnosis.

After their initial scans, the 82 patients were given one of two RA drug courses. After a year of treatment, further scans were then carried out on 71 of the patients.The scans revealed that the vascular stiffness of the aorta (the main artery) had improved during the RA therapy.

“The rheumatoid arthritis treatment improved vascular stiffness, regardless of how the patient responded to the RA medication and these improvements in vascular stiffness independently of response to RA treatment were unexpected,” Plein said.

The research highlights the importance of commencing treatment of RA early to also lessen the risk of developing CVD.

“Identifying patients at the earliest stage of RA with most risk of CVD is important to inform management strategy,” said study researcher Maya Buch.

“The benefits of RA treatment on CVD extend beyond traditional suppression of inflammation,” Buch noted.