Journal
RHEUMATOLOGY
Volume 62, Issue 9, Pages 2998-3005Publisher
OXFORD UNIV PRESS
DOI: 10.1093/rheumatology/kead039
Keywords
RA; cardiovascular event; treat-to-target; case-control study
Categories
Ask authors/readers for more resources
This study aimed to investigate whether the excess cardiovascular disease risk in rheumatoid arthritis (RA) patients could be reduced by using a treat-to-target (T2T) approach to suppress inflammation. The results showed that early RA patients managed by T2T strategy had a similar incidence of cardiovascular events (CVE) compared to non-RA individuals and a historical RA cohort. Therefore, T2T strategy can effectively lower the cardiovascular risk in RA patients.
Objectives This study explored whether the excess cardiovascular (CV) disease (CVD) risk in RA could be ameliorated by suppression of inflammation using a treat-to-target (T2T) approach. We compared the CV event (CVE) incidence among ERA patients managed by a T2T strategy with a CV risk factor-matched non-RA population and a historical RA cohort (HRA). Methods This was an observational study using the city-wide hospital data and the ERA registry. ERA patients received T2T management while HRA patients received routine care. Each ERA/HRA patient was matched to three non-RA controls according to age, gender and CV risk factors. Patients on antiplatelet/anticoagulant agents, with pre-existing CVD, chronic kidney disease or other autoimmune diseases were excluded. All subjects were followed for up to 5 years. The primary end point was the first occurrence of a CVE. Results The incidence of CVE in the ERA cohort (n = 261) and ERA controls were similar with a hazard ratio of 0.53 (95% CI 0.15, 1.79). In contrast, the incidence of CVE in the HRA cohort (n = 268) was significantly higher than that of the HRA controls with a hazard ratio of 1.9 (95% CI 1.16, 3.13). The incidence of CVE in the ERA cohort was significantly lower than that of the HRA cohort and the difference became insignificant after adjusting for inflammation, the use of methotrexate and traditional CV risk factors. Conclusion ERA patients managed by a T2T strategy did not develop excess CVE compared with CV risk factor-matched controls over 5 years.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available