Cho SK, et al. – The specialists attempted this study to assess the incidence of cardiovascular disease (CVD) in Asian patients with rheumatoid arthritis (RA) and to determine the impact of anti–rheumatic treatment on the development of CVD. Results confirmed that the use of disease modifying anti–rheumatic drugs (DMARDs) was protective against CVD, while corticosteroids and NSAIDs increased the risk of CVD in RA patients.

Methods

• This study included Asian patients with RA to identify the incidence rate (IR) of CVD in these patients. 
• The Korean National Healthcare claims database was utilized, which contained claims from Jan 2009 to Dec 2013. 
• A total of 137,512 RA patients were identified.
• Individuals with a history of CVD for 6 months or more before the index date were excluded.
• Nested case–control samples were drawn from the full study population with a case:control ratio of 1:4 (n=7,102 cases; n=27,018 controls without CVD). 
• A conditional multivariate regression model was used to evaluate the impact of anti–rheumatic treatment on the development of CVD in RA patients after matching for age, sex, RA index date, comorbidities, and drug use (e.g., antiplatelet agents, cholesterol–lowering agents).

Results

• Investigations displayed that the IR for development of overall CVD in RA patients was 182.1 (95% CI 178.4–185.9) per 10,000 person–years.
• In models adjusted for other CVD risk factors, disease–modifying anti–rheumatic drugs (DMARDs) (OR 0.79) were protective against CVD, and biologic DMARDs were not significantly associated with CVD risk (OR 0.85).
•  In RA patients, corticosteroids (OR 1.26) and NSAIDs (nonselective NSAIDs: OR 1.32, Cox–2 inhibitors: OR 1.31) were risk factors for CVD.