ARD: Short-, medium-, and long-term risk of acute coronary syndrome in a cohort of RA patients using biological DMARDs: results from four Nordic countries

Objective: Patients with rheumatoid arthritis (RA) are at increased risk of acute coronary syndrome (ACS) and other cardiovascular diseases, but different biological / targeted synthetic disease-modifying antirheumatic drugs (b/ tsDMARDs) is unclear, and most studies compared the risk of one b/tsDMARD to another, not all available b/ tsDMARDs
.

The aim of this study was to compare the 1- , 2- , and 5 -year ACS incidence in patients with RA who were initiated on any of the biological disease-modifying antirheumatic drugs (bDMARDs) currently available in clinical practice, and with the general population .

Objective: Patients with rheumatoid arthritis (RA) are at increased risk of acute coronary syndrome (ACS) and other cardiovascular diseases, but different biological / targeted synthetic disease-modifying antirheumatic drugs (b/ tsDMARDs) is unclear, and most studies compared the risk of one b/tsDMARD to another, not all available b/ tsDMARDs

Methods: Observational cohort study of patients from Denmark, Finland, Norway, and Sweden who started bDMARD therapy between 2008 and 2017 .

Determine the time of your first ACS via the registration link .

Methods: Observational cohort study of patients from Denmark, Finland, Norway, and Sweden who started bDMARD therapy between 2008 and 2017 .
Determine the time of your first ACS via the registration link .
We calculated 1- , 2- , and 5 -year incidence rates (IR) (after drug therapy and treatment initiation) and compared ACS incidence across treatments (taking into account ACS risk factors) using Cox regressions (HRs ) .
Further separate analyses were performed in subgroups defined by age, number of previous bDMARDs , and history of cardiovascular disease .
The investigators also compared ACS incidence with a separately matched general population cohort .

RESULTS: A total of 24,083 patients ( 75% women, mean age 56 years) of 40,850 courses were included .

During the longest ( 5 -year) follow-up period ( 141,257 person-years ( pyrs )), 780 ACS events occurred (crude IR 5.
5/1000 pyrs ) .
Overall, the incidence of ACS in RA is 80% higher than in the general population .
HR was close to 1 (etanercept as reference) for all bDMARDs and different follow-up time points, except for the 5 -year risk window, where abatacept ( ABA ), infliximab ( INF ) and rituximab ( RIT ) HR value greater than 1 .

RESULTS: A total of 24,083 patients ( 75% women, mean age 56 years) of 40,850 courses were included .
During the longest ( 5 -year) follow-up period ( 141,257 person-years ( pyrs )), 780 ACS events occurred (crude IR 5.
5/1000 pyrs ) .
Overall, the incidence of ACS in RA is 80% higher than in the general population .
HR was close to 1 (etanercept as reference) for all bDMARDs and different follow-up time points, except for the 5 -year risk window, where abatacept ( ABA ), infliximab ( INF ) and rituximab ( RIT ) HR value greater than 1 .

     Conclusions: Compared with the general population, RA patients using bDMARDs had a higher incidence of ACS .

The short-, mid-, and long-term risks of ACS did not differ significantly between bDMARDs when used in usual care .
 

     Conclusions: Compared with the general population, RA patients using bDMARDs had a higher incidence of ACS .
The short-, mid-, and long-term risks of ACS did not differ significantly between bDMARDs when used in usual care .
 

Source: Delcoigne B, Ljung L, Provan SA , et al .

Short-term, intermediate-term and long-term risks of acute coronary syndrome in cohorts of patients with RA starting biologic DMARDs: results from four Nordic countries.
Annals of the Rheumatic Diseases.
  Published Online First: 22 March 2022.
doi: 10.

Delcoigne B, Ljung L, Provan SA , et al .
Short-term, intermediate-term and long-term risks of acute coronary syndrome in cohorts of patients with RA starting biologic DMARDs: results from four Nordic countries.
Annals of the Rheumatic Diseases.
  Published Online First: 22 March 2022.
doi: 10.
1136/annrheumdis-2021-221996 , et al Annals of the Rheumatic Diseases.
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