| ent study has shown that the use of a combination of | | | | DMARDS; and 4,943 took TNF-inhibitors. Exposure of |
| a tumor necrosis factor (TNF) inhibitor along with | | | | one group of patients to TNF-inhibitors (taken alone or |
| methotrexate therapy in people with rheumatoid | | | | in combination with methotrexate) was compared to |
| arthritis (RA) was associated with a reduction in heart | | | | that of the other group taking methotrexate alone. |
| attack risk of 80 percent compared with patients using | | | | During the study period, 441 patients suffered heart |
| methotrexate alone, according to research presented | | | | attacks, of which eight percent were fatal. |
| recently at the American College of Rheumatology | | | | Researchers found that patients on a combination of |
| Annual Scientific Meeting in Boston, Mass. | | | | TNF-inhibitors with methotrexate treatment had a |
| Rheumatoid arthritis is a chronic, systemic, autoimmune | | | | heart attack risk of only 20 percent of the risk |
| disease that not only causes pain, stiffness, swelling, | | | | compared to patients taking methotrexate alone. |
| and limitation of function in joints, but also damages | | | | However, there was no statistical difference seen |
| internal organs as well. | | | | among patients who were taking TNF-inhibitors alone, |
| Approximately, 2.1 million Americans are afflicted with | | | | TNF-inhibitors with other DMARDs, other DMARD |
| RA, most of them women. As mentioned above, while | | | | therapies without methotrexate, or a combination of |
| joints are the principal areas affected by RA, | | | | DMARDs and methotrexate. Therefore, this reduction |
| inflammation can develop in other organs as well. Heart | | | | in cardiovascular events appears to be a function of |
| attacks, resulting from inflammation of the coronary | | | | the combination of methotrexate and TNF-inhibitors. |
| vessels, are more common in RA sufferers. | | | | “TNF-inhibitor therapy, in combination with |
| Researchers recently studied the risk of heart attack | | | | methotrexate, dramatically reduces the risk of heart |
| in patients using a TNF-inhibitor (a drug that blocks | | | | attacks in patients with RA and should be seriously |
| cytokines and can turn off the chronic inflammation | | | | considered— especially in high-risk |
| that causes destruction in RA), methotrexate (a drug | | | | patients,” said Gurkirpal Singh, MD, clinical |
| used to treat RA by blocking the metabolism of cells) | | | | professor of medicine in the division of |
| and other disease modifying anti-rheumatic drugs | | | | gastroenterology at Stanford University School of |
| (DMARDs), which are a category of drugs used in RA | | | | Medicine, and an investigator in the study. |
| to slow down the disease progression, in a large | | | | The notion that RA is a potentially crippling disorder is |
| population of patients with RA—many of whom | | | | widely accepted. However, what is not generally |
| were also taking aspirin. | | | | known is that it is a potentially lethal disease leading to |
| Using information obtained from MediCal, | | | | an increased risk of heart attack and stroke. |
| California’s Medicaid program, researchers | | | | It is imperative that patients with RA understand the |
| studied patients over the age of 18, suffering from RA, | | | | systemic nature of this condition and the need for |
| who were treated with TNF-inhibitors, methotrexate, or | | | | aggressive intervention. This study lends more |
| other DMARDs, over a six-and-a-half year period. | | | | ammunition to the argument that patients with RA |
| A total of 19,233 patients with RA were identified. The | | | | need to be treated with a combination of |
| patients’ mean age was 55 years. | | | | methotrexate and biologic therapy to not only reduce |
| Approximately 79 percent were women. Of these | | | | the chances for crippling deformity but also to reduce |
| patients, 13,383 took methotrexate; 14,958 took other | | | | the likelihood of cardiovascular death. |