Vascular effects of biologic and targeted synthetic antirheumatic drugs approved for rheumatoid arthritis: a systematic review

被引:8
作者
Gerganov, Georgi [1 ,2 ]
Georgiev, Tsvetoslav [2 ,3 ]
Dimova, Maria [1 ,4 ]
Shivacheva, Tanya [2 ,3 ]
机构
[1] Med Univ Varna, Fac Med, Dept Propedeut Internal Med, Varna 9002, Bulgaria
[2] Univ Hosp St Marina Varna, Clin Rheumatol, Varna 9010, Bulgaria
[3] Med Univ Varna, Fac Med, Dept Internal Med 1, Varna 9002, Bulgaria
[4] Univ Hosp St Marina Varna, Clin Internal Med, Varna 9010, Bulgaria
关键词
Rheumatoid Arthritis; Cardiovascular Risk; Biological Therapy; Systematic Review; Antirheumatic Agents; IMPROVES ENDOTHELIAL FUNCTION; INTIMA-MEDIA THICKNESS; NECROSIS-FACTOR ANTAGONISTS; FACTOR-ALPHA THERAPY; ARTERIAL STIFFNESS; AORTIC STIFFNESS; CARDIOVASCULAR OUTCOMES; MYOCARDIAL DEFORMATION; ADHESION MOLECULE; DISEASE-ACTIVITY;
D O I
10.1007/s10067-023-06587-8
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Rheumatoid arthritis (RA) increases the risk of cardiovascular disease (CVD), with inflammation playing a key role. Biologic and targeted synthetic drugs used to treat RA can induce systemic immunomodulation and may have pleiotropic effects on vascular function, making it crucial to investigate their impact on CVD risk in RA patients. Methods A systematic review of the literature was conducted to investigate the impact of biologic and targeted synthetic treatments approved for RA on various cardiovascular markers, including endothelial function, arterial stiffness, and subclinical atherosclerosis. Our analysis included a search of the MedLine (via PubMed) and Web of Science databases using a pre-determined search strategy. We conducted a narrative synthesis of the included studies due to heterogeneity in study design and outcome measures. Results From an initial pool of 647 records, we excluded 327 studies based on their titles and abstracts, and we selected 182 studies for final examination. Ultimately, 58 articles met our inclusion criteria and were included in our systematic review. Our analysis of these studies revealed a positive effect of biologic and targeted synthetic therapies on vascular dysfunction associated with RA. However, the impact of these treatments on subclinical atherosclerosis was inconsistent. Conclusion Overall, our systematic review provides important insights into the potential cardiovascular benefits of biologic and targeted synthetic treatments for RA by a still unknown mechanism. These findings can inform clinical practice and contribute to our understanding of their possible effects on early vascular pathology.
引用
收藏
页码:2651 / 2676
页数:26
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