Treating rheumatoid arthritis, biologics benefit more from cardiovascular disease! EULAR 2020.

Don't want to miss Jiemei's push? Poke the blue word "medical rheumatism and nephropathy channel" to pay attention to us and click the "··" menu in the upper right corner and select "set as star" EULAR 2020. Let's listen together! The incidence rate and mortality of CVD in rheumatoid arthritis (RA) patients increased significantly, and CVD was one of the common causes of death in RA patients.in addition to the traditional risk factors (age, smoking, hypertension, hyperlipidemia, etc.), chronic inflammation is the main risk factor of cardiovascular disease in RA, and long-term inflammatory activity will significantly increase the risk of cytomegalovirus (CMV).this 2020 EULAR online annual meeting pushed forward two prospective clinical studies on RA disease activity and related treatment and the risk of CVD."rheumatism and nephropathy channel of medical circles" specially invited Zhang Xia, chief physician of Rheumatology and Immunology Department of people's Hospital of Peking University, to give us a wonderful report of the meeting.a multi center prospective observational clinical study (nor-dmard) from diakonhjoment hospital, Oslo, Norway, reported that remission of RA significantly reduced the incidence of CVD, and biological agents (bdmads) were more beneficial to CVD in patients with remission.in this multicenter study, 2305 patients were treated with bdmads and 620 patients were treated with csdmards. At 6 months, the incidence of CVD in patients in remission was significantly lower than that in patients without remission.Cox regression analysis showed that the incidence of CMV in remission group was significantly lower than that in non remission group (P & lt; 0.01).although the incidence of CVD in csdmards group was higher than that in bdmads group, there was no statistically significant difference between the two groups, and further research is needed to clarify in the future.(II) George karpouzas, from the harbor UCLA Medical Center in Torrance, California, USA, reported a single center prospective clinical study on reducing the risk of CVD with bdmads. It was found that bdmads treatment can reduce the risk of long-term cardiovascular events in RA patients by inhibiting the formation of coronary plaque and enhancing the stability of high-risk plaque.150 patients with RA were enrolled in this study. Among them, 110 patients were treated with bdmads and 36 patients were not treated with bmards. The patients were followed up for 6.9 ± 0.3 years. The progression of coronary atherosclerotic plaque was evaluated by coronary CT angiography.the study found that the incidence of CVD in patients with low attenuation plaque and non calcified plaque at baseline was significantly reduced (P = 0.022,0.049).the analysis of plaque progression at each segment showed that the use of bdmads could reduce the formation of new plaque in patients without mixed plaque in other parts of coronary artery (or = 0.4, P = 0.034).at the same time, the use of bdmads can promote the transition from non calcified plaque to mixed plaque (or = 4, P = 0.043), enhance the stability of plaque, and long-term biological agent treatment is conducive to the disappearance of low attenuation plaque, thus reducing the risk of CVD.in conclusion, the control of RA remission is an important measure to reduce the incidence of cardiovascular disease. The above research provides more evidence-based medical evidence for the clinical biological treatment of RA, and provides guidance for the management of cardiovascular risk of RA.