Accelerated Atherosclerosis in Rheumatoid Arthritis: Mechanisms and Treatment


Hello from my office on long island in new york um welcome to accelerated atherosclerosis in rheumatoid arthritis mechanisms and treatment in current pharmaceutical design the authors including myself are andrew silverman mohamed khalfan nicholas a vernisse laura j castleman stephen e carsons and joshua deleon at nyu long island school of medicine the

Subject of rheumatoid arthritis and cardiovascular disease is a very important one clinically rheumatoid arthritis is a chronic systemic inflammatory autoimmune disease the most obvious symptoms that cause distress to patients are the joint swelling pain and destruction but nra cvd is in fact the leading cause of death one of the problems is that it’s very

Difficult to find those likely to develop cvd the patients that you want to treat proactively that is because when you calculate cvd risk using the methods for the general population they’re inadequate and underestimate risk in ra and we’re working hard at trying to resolve this problem and get better predictors that we can use for this patient population

Why is the risk of cardiovascular disease so great in ra well it’s mostly attributed to an inflammatory environment that leads to disruptive lipid transport vascular inflammation oxidative stress poor quality hdl and small dense ldl ra plasma has atherogenic properties the plasma of people with rheumatoid arthritis has the ability to disrupt cholesterol

Metabolism and transport in monocytes macrophages and endothelium within blood vessels there’s also a plethora of inflammatory cytokines that are elevated in rheumatoid arthritis including tnf alpha il1 and il-6 and the combination of the abnormalities in the cholesterol handling and the cytokine profile leads to an atherosclerosis promoting environment this

Is just a depiction from our paper of how that occurs and encourages the formation of foam cells which are the hallmark cells in atherosclerosis so this kind of sets the stage to describe why it’s so important to treat patients with ra so that they don’t die of cardiovascular disease but how do we treat atherosclerotic cardiovascular disease and rheumatoid

Arthritis well one of our most used drugs for cardiovascular disease is statins but they are not enough the residual risk is unacceptably high even in ra patients given statins and we also are not sure which patients need or benefit from the statins so this review evaluates the effects on cardiovascular health of mainstay treatments for ra drugs such as

The analgesics opioids non-steroidal anti-inflammatory drugs and acetaminophen the demods the disease-modifying anti-rheumatic drugs such as methotrexate sulfasalazine and hydroxychloroquine and the tnf inhibitors those neutral or biological drugs that are given either in addition to methotrexate or as monotherapy but ultimately we need a more focused and

Effective approach to mitigating ascvt risk in the ra population i hope that you will read further and explore uh these different drugs and drug classes and how they affect cardiovascular disease because we go into a lot of detail in the paper itself i want to thank all of my co-authors and i want you to see all of their faces these are the people that

Did this work we are a team and a village and we appreciate you listening and we hope you look at our paper and um you can get in touch with us as needed uh through our email and thank you again and have a wonderful day you

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Accelerated Atherosclerosis in Rheumatoid Arthritis: Mechanisms and Treatment By Bentham Science