An anti-arthritis drug also was linked with improved signs for the early stages of cardiovascular disease, a new study from ESC 2020 suggests.
The researchers wrote that the study objective was “to determine whether patients with early rheumatoid arthritis (ERA) have cardiovascular disease (CVD) that is modifiable with disease-modifying antirheumatic drug (DMARD) therapy, comparing first-line etanercept (ETN) + methotrexate (MTX) with MTX strategy.”
The study included 82 patients with early rheumatoid arthritis and no known heart issues. Patients were randomized to receive either ETN+MTX or MTX with or without a month-six escalation to ETN+MTX. Patients, while not having known cardiovascular disease, had at least one risk factor and underwent cardiovascular magnetic resonance imagine. There were 30 matched controls who also underwent CMR. The primary study outcome of interest was aortic distensibility between controls and those with early rheumatoid arthritis, as well as baseline-to-one-year change in early rheumatoid arthritis.
According to the results, in patients with early rheumatoid arthritis, baseline aortic distensibility was significantly lower (P<0.001), as was LV mass significantly lower (P<0.01); and myocardial extracellular volume increased (P<0.01). Aortic distensibility improved across all patients, and significantly (P<0.001), from baseline out to one year. The benefit appeared to be maintained at year two as well.
“Identifying patients at the earliest stage of RA with most risk of CVD is important to inform management strategy,” Prof. Maya Bunch, joint research lead on the study, said in a press release. “The benefits of RA treatment on CVD extend beyond traditional suppression of inflammation. Until further data are acquired, these data also suggest we should be cautious if considering a reduction in RA therapy (due to good joint control) for concern of risk of CVD progression.”
She added: “We now need to ensure the link between early RA and CVD morbidity remains a central area of research, and work towards tailoring therapies to address both RA joint disease and associated CVD.”
The study was published online in the Annals of the Rheumatic Diseases.
First- line etanercept with methotrexate, or methotrexate- treat- to- target strategy in early #rheumatoidarthritis improves vascular stiffness (associated with major cardiac events) on cardiac MRI compared to matched controls https://t.co/cLoUBsUqBl #CMR pic.twitter.com/BmpXgd1574
— ARD & RMD Open (@ARD_BMJ) September 2, 2020
— Dr Ai Lyn Tan (@DrAiLynTan) September 2, 2020