Biologics and the cardiovascular system: a double-edged sword.

Abstract

Patients with chronic inflammatory diseases such as rheumatoid arthritis have a higher risk of cardiovascular diseases and related mortality compared to the general population. This risk is first due to classical cardiovascular risk factors but also due to systemic inflammation which is independently involved, causing accelerated atherosclerosis, myocardial infarction, cerebrovascular disease and heart failure (HF). Pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-1 and IL-6 could be major actors on this pathophysiology. Biologics are effective specific treatments in the management of inflammatory rheumatic and systemic diseases. In this review, beneficial and deleterious effects on the heart and vessels of the biologics used in the management of inflammatory arthritis and vasculitides will be discussed, focusing on TNF-alpha, IL-6 and IL-1 blockades, and anti-CD20. Noninflammatory cardiac conditions, such as heart failure, myocardial infarction, and cardiovascular conditions such as atherosclerosis, as well as inflammatory diseases including vasculitides will be discussed.

• Authors: Camille Roubille, Johanne Martel-Pelletier, Boulos Haraoui, Jean-Claude Tardif, Jean-Pierre Pelletier
• Journal: Anti-inflammatory & anti-allergy agents in medicinal chemistry (Antiinflamm Antiallergy Agents Med Chem) Vol. 12 Issue 1 Pg. 68-82 ( 2013) ISSN: 1875-614X [Electronic] United Arab Emirates
• PMID: 23286291 (Publication Type: Journal Article, Review)

Chemical References

• Antibodies, Monoclonal
• Interleukin-1
• Interleukin-6
• Tumor Necrosis Factor-alpha

Topics

• Antibodies, Monoclonal (adverse effects, immunology, therapeutic use)
• Arthritis, Rheumatoid (therapy)
• Cardiovascular Diseases (therapy)
• Cardiovascular System (drug effects)
• Clinical Trials as Topic
• Humans
• Interleukin-1 (immunology)
• Interleukin-6 (immunology)
• Tumor Necrosis Factor-alpha (immunology)
• Vasculitis (therapy)