The impact of certain drugs used to treat rheumatoid arthritis (RA), especially biologic immunosuppressive drugs or "biologicals," has been a controversial subject for years. Now, a preliminary analysis suggests that prolonged used of these agents by RA patients is linked to a reduction in cardiovascular risk when compared with the use of methotrexate and other so-called disease-modifying antirheumatic drugs, or DMARDs.

However, the findings must be taken "cautiously," said lead authors Drs. Santiago Ag?ero, of the San Juan Baustista Hospital in Catamarca, Argentina, and Antonio Naranjo of the Gran Canaria Hospital "Dr. Negrin" in Spain.

"Early use of biologicals to control rheumatoid arthritis and induce remission might be linked to a diminished cardiovascular risk, but this is still hypothetical," they told Reuters Health.

The study reviewed data from 4,363 patients on drug therapy for RA. Most patients were female (78 percent) and their mean age was 57 years old.

In "adjusted" analyses, researchers found that patients treated with biologics had a significantly reduced lifetime risk of experiencing a cardiovascular event such as heart attack, heart disease and stroke, compared with those treated with methotrexate, leflunomide, sulfasalazine and glucocorticoids.

Results were presented at the 40th Argentine Congress of Rheumatology.

The intrinsic process involved in the development of rheumatoid arthritis might also damage the blood vessels. Most antirheumatic biologic agents block TNF, a mediator previously shown to interfere with the lining of blood vessels, promote plaque rupture, and induce an unhealthy "prothrombotic state" ï¿½?that is, prone to blood clot formation.

We now must study "whether biologicals have the capacity of reversing the cardiovascular effects of TNF in a sustained way," he added.

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