Addition of Immunomodulators Cuts Vascular Inflammation in RA

MONDAY, Dec. 12, 2022 (HealthDay News) -- For patients with rheumatoid arthritis (RA), the addition of a tumor necrosis factor (TNF) inhibitor (TNFi) or addition of sulfasalazine and hydroxychloroquine (triple therapy) to methotrexate results in clinically important improvements in vascular inflammation, according to a study recently published in the Annals of Rheumatic Diseases.

Daniel H. Solomon, M.D., M.P.H., from Brigham and Women's Hospital in Boston, and colleagues randomly assigned 115 patients with active RA despite use of methotrexate to addition of a TNFi or addition of sulfasalazine and hydroxychloroquine for 24 weeks. Changes in arterial inflammation were examined as an index of cardiovascular risk, measured as an arterial target-to-background ratio (TBR) in the carotid arteries and aorta.

The researchers observed significant TBR reductions in both groups (ΔTNFi, −0.24; Δtriple therapy, − 0.19), with no significant difference seen between the groups. Both groups had significant reductions in disease activity, but no association was seen with change in TBR.

"Our results highlight the importance of conducting clinical trials specifically among patients with RA rather than the general population," Solomon said in a statement. "Prior trials in the general population have shown differential effects on cardiovascular risk between different immunomodulators, but in our trial, two different immunomodulator treatment strategies produced similar reductions in cardiovascular risk."

Several authors disclosed financial ties to pharmaceutical companies, including AbbVie and Amgen, which supplied the study drugs.

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