Heart Risk: Arthritis Drugs Compared
Study: Newest Rheumatoid Arthritis Drugs No Better or Worse at Cutting Heart Risks
Nov. 29, 2006 - A new class of rheumatoid arthritis drugs is no different at
cutting heart attack and stroke risk than an older treatment, a Harvard study
In the study, patients taking biologics, which are designed to suppress a
specific part of the immune system, were compared with patients taking only
methotrexate, an older drug commonly used for rheumatoid arthritis.
Those taking biologics, such as Enbrel, Humira, Remicade, or Kineret, fared
no better or worse than those on methotrexate alone, in terms of risk for heart
attack or stroke, the study shows.
These drugs are called biologics because they are derived from living
However, the study did show that people taking oral steroids “appeared to
have slightly greater cardiovascular risk” than patients who only took
Comparing Heart Risk
In rheumatoid arthritis, the immune system attacks the body instead of
defending it. Doctors often prescribe drugs to suppress the immune system in
order to control the disease.
Rheumatoid arthritis is also associated with a rise in heart risks.
This added risk is thought to be tied to the inflammation that is a key
component of rheumatoid arthritis - and is increasingly thought to play a part
in the development of heart diseaseas well.
This study, from Daniel Solomon, MD, MPH, and colleagues, looked at data
from about 3,500 rheumatoid arthritis patients enrolled in Medicare.
The patients were 82 years old, on average. Most were elderly white women in
The patients had filled prescriptions for various drugs designed to suppress
the immune system.
Over two years, 946 patients were hospitalized for a heart attack or stroke.
Those taking biologic drugs weren't any more or less likely to have a heart
attack or stroke than those only taking methotrexate.
While those taking oral steroids did appear to be more at risk than those on
methotrexate, the researchers caution that this could be because methotrexate
and biologic drugs may both protect the heart.
If that is the case, oral steroids may falsely look risky in comparison. The
study doesn't settle that question.
The study has some limits.
The data didn't include information on some things that may affect
cardiovascular risk, such as smoking, aspirin use, and BMI (body mass index) --
a gauge for appropriate weight.
With a mainly frail, elderly population, it was also hard to rule out other
The study was published in Arthritis & Rheumatism.
It was funded in part by the drug companies Merck, Pfizer, and Savient.
Merck and Pfizer are WebMD sponsors.
One of the researchers -- Michael Weinblatt, MD -- reports receiving
consulting fees from various drug companies.