The Impact of Biological Therapy on Cardiovascular Disease Risk Among Patients with Rheumatoid Arthritis

Document Type : Review Articles

Authors

1 Resident of Rheumatology, Physical Medicine & Rehabilitation, Diarb Negm Central Hospital

2 Assistant Professor of Rheumatology, Physical Medicine &Rehabilitation, Faculty of Medicine, Zagazig University

3 Professor of Cardiology, Faculty of Medicine - Zagazig University

4 Professor of Rheumatology, Physical Medicine &Rehabilitation, Faculty of Medicine - Zagazig University

Abstract

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent synovial inflammation and progressive joint destruction. Beyond its musculoskeletal manifestations, RA is associated with a markedly increased risk of cardiovascular disease (CVD), which has become a leading cause of morbidity and mortality in this population. Systemic inflammation, immune dysregulation, and the presence of traditional cardiovascular risk factors collectively accelerate atherosclerosis and vascular dysfunction in RA patients. This review aims to examine the complex relationship between RA and cardiovascular disease by exploring the underlying pathophysiological mechanisms, the prevalence and spectrum of cardiovascular manifestations, key risk factors including inflammation, oxidative stress, and endothelial dysfunction and the impact of RA treatments on cardiovascular outcomes.

Conclusion: The interplay between chronic inflammation and cardiovascular pathology in RA necessitates a multidimensional approach to patient care. While traditional risk factors contribute to cardiovascular burden, RA-specific mechanisms significantly influence disease progression. Anti-inflammatory therapies, especially biologics and targeted agents, can modify cardiovascular risk, though their safety profiles vary. While MTX continues to play a foundational role in RA management, emerging evidence supports a more prominent place for biologics and JAK inhibitors when cardiovascular outcomes are a major concern. These therapies not only improve musculoskeletal outcomes but also help in addressing the silent and often deadly burden of cardiovascular disease in RA patients. Tailoring therapy based on individual risk profiles may ultimately lead to better long-term outcomes and quality of life.

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Zagazig University Medical Journal
Volume 31, Issue 8
August 2025
Pages 4264-4273

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