Immunotherapy cuts heart disease risk in arthritis patients

Immunotherapy has the potential to reduce the risk of heart disease in patients suffering with rheumatoid arthritis, finds a study. Rheumatoid arthritis is an autoimmune disease in which cytokines such as tumour necrosis factor-alpha (TNFI) and interfero-gamma (IFN), which normally protect the body, attack healthy cells The findings showed that the combination of two anticytokines containing extra-low doses of antibodies against TNFI and IFN could improve the efficacy of standard rheumatoid arthritis therapy and decrease heart disease risk.

"In rheumatoid arthritis, patients have painful and inflamed joints. They are also at increased cardiovascular risk, particularly if their rheumatoid arthritis is not controlled," said Aida Babaeva, Professor at Volgograd State Medical University in Russia. Further, the patients taking the combination of anticytokines had a lower rheumatoid arthritis disease activity score, as measured by the DAS28,2 and more dramatic decreases in IL-1, IL-6 and TNF alpha than the group on standard therapy alone.

The incidence of cardiovascular events (unstable angina, severe hypertensive crisis, and deterioration of chronic heart failure) was more than double in the group on conventional disease-modifying drugs alone (37 per cent) compared to those also taking the combination of anticytokines (13 per cent). "Our findings suggest that the decreased rheumatoid arthritis disease activity with the combination of anticytokines translates into decreased cardiovascular risk," Babaeva said.

Rheumatoid arthritis is also associated with dysfunction of the blood vessel lining (called endothelium), which leads to lipid accumulation in the artery wall, plaque formation and atherosclerosis. "Thus, decreasing disease activity may also reduce cardiovascular risk by slowing down or halting these processes," Babaeva added. For the study, the team included 68 patients who had suffered from active rheumatoid arthritis for at least five years.

Patients were randomised to receive the combination of anti-TNF alpha and anti-IFN gamma plus standard disease-modifying therapy (38 patients) or placebo plus standard therapy (30 patients). We recommend this new approach for preventing cardiovascular events in patients with moderate disease activity who are not receiving the standard biologics and who do not have severe complications." The research was presented at the Frontiers in CardioVascular Biology (FCVB) 2016 in Italy, recently.