In the latest entry to my chronic pain blog, I discuss the increased risk of heart attack with the use of anti-inflammatory medications. Unfortunately, I have found that many patients are of the opinion that any drug which helps their joints might harm their heart.
But this is not the case.
Data presented at this summer’s congress of the European League Against Rheumatism showed that rheumatoid arthritis patients on tumor necrosis factor inhibiting drugs such as Enbrel, Remicade or Humira had twice the reduction in stroke incidence compared with patients not treated with these medications. It also appears these medications might reduce heart attack risk. But the effect appears limited to patients who are responding to those medications.
Because inflammation is thought to play a role in both rheumatoid arthritis and cardiovascular disease, it would appear that a drug such as Enbrel, which inhibits joint inflammation, also reduces inflammation in the arteries. This is extremely important, because the leading cause of death in rheumatoid arthritis patients is heart attack and stroke. Using Enbrel, Humira or Remicade not only quiets the inflammation that causes painful joints, but these drugs can possibly reduce the death rate in rheumatoid arthritis patients.
Despite this promising data, more patients must be studied over a longer period of time before we can definitively say that the tumor necrosis factor inhibiting drugs are lifesavers.
However, in this month’s issue of Arthritis Care and Research, it was found that exposure to the traditional rheumatoid arthritis drugs (methotrexate and Arava included) appears to decrease the risk of heart attack. This could be due to the direct effect of lowering inflammation in the arteries, or these drugs might have an indirect effect by allowing patients to feel better: When someone feels less pain and stiffness, they become more physically active and we all know the benefits to the cardiovascular system of physical exercise.
Again, more patients must be analyzed over longer periods of time. But these initial data are certainly promising, and a cause for optimism in patients suffering the chronic inflammation of rheumatoid arthritis.
Published On: September 15, 2006