Background:

Patients with systemic autoimmune rheumatic diseases (SARDs), like systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and rheumatoid arthritis (RA), are at an elevated risk of heart failure, found a study declared in the Journal of American College of Cardiology. The influence of comorbidities, demographic factors and medications on heart failure was intended to be evaluated by this study.

Method:

Adult patients with SARDs like SLE, SSc, or RA were included in a retrospective cohort study. Patient data between 2000 and 2020 was collected for the investigation. The electronic medical record was used to gather disease-modifying antirheumatic drug (DMARD) usage details, comorbidity status, demographics and incidence of heart failure. The link between DMARD exposure and heart failure was examined by performing multivariable logistic regression.

Results:

The study enrolled 86,491 patients, of which as many as 60,229 had RA and 20,740 had SLE. Only 5,558 presented with SSc.

Heart failure was diagnosed in 16% RA and 14.1% SLE patients.

By univariate analysis, all the three subgroups exhibited significant association of the following factors with heart failure:

  • Race

  • Gender

  • Age

  • Diabetes

  • Ischemic heart disease

  • Hypertension

Whereas only RA and SLE demonstrated a link of BMI with heart failure, p < 0.001.

A significant association was noted between the use of mycophenolate and the incidence of heart failure.

  • RA: Odds ratio (OR): 1.96; Confidence interval (CI): 1.66-2.31; p < 0.001

  • SLE: OR: 1.38; CI: 1.20-1.59; p < 0.001

  • SSc (OR: 1.83; CI: 1.52-2.21; p < 0.001

 

In RA patients, the use of TNF inhibitor, methotrexate and anakinra for treatment was also observed to increase the risk of heart failure.

  • TNF inhibitor: OR: 0.77; CI: 0.72 - 0.85; p < 0.001

  • Methotrexate: OR: 0.81; CI: 0.77-0.86; p < 0.001

  • Anakinra: OR: 2.20; CI: 1.27-3.74; p = 0.05

Conclusion:

The usage of mycophenolate for treating RA, SLE and SSc patients was linked with the elevated risks of incidence of heart failure.

 

post
Keywords

Disease Condition,Therapeutic Modality,Heart Failure,Pharmacotherutics,TPHT_others

Source

https://medicaldialogues.in/cardiology-ctvs/news/dmard-therapy-in-autoimmune-diseases-may-increase-heart-failure-risk-jacc-79704