Similarities in the inflammatory response seen in atherosclerosis and in rheumatoid arthritis (RA) have raised interest for the study of the molecular mechanisms of rheumatoid arthritis, in order to potentially learn more about the mechanisms of atherosclerosis.

Several markers of inflammation have been associated with increased vascular risk, including high-sensitivity C-reactive protein (hsCRP), serum amyloid A, soluble intercellular adhesion molecule-1, tumor necrosis factor-alpha (TNF-a), and interleukin-6 (IL-6).

Observational studies show increased standardized mortality in RA patients compared to non-RA patients, a substantial proportion of the excess risk being attributable to coronary heart disease. Can targeted anti-inflammatory therapy reduce cardiovascular risk in these patients? The TARA randomized placebo-controlled clinical trial of atorvastatin in RA showed significantly reduced hsCRP levels in addition to reduced disease activity score, however further longer-term studies are needed to determine any effect on cardiovascular risk. Some non-randomized data suggest reduced cardiovascular mortality with methotrexate or TNF inhibition in RA patients, and the randomized OPTION trial has also demonstrated hsCRP lowering with tocilizumab, an IL-6 inhibitor, in combination with methotrexate in RA patients. Dr. Ridker discusses these and other studies, and a cost-effective approach to cardiovascular risk screening.

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After viewing this presentation, the participant will be able to:
- Explain common biologic pathways that link cardiovascular disease and rheumatoid arthritis
- Identify common biologic pathways that potentially link therapies for cardiovascular disease and rheumatoid arthritis

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