Title:Biologics and the Cardiovascular System: A Double-Edged Sword
Volume: 12
Issue: 1
Author(s): Camille Roubille, Johanne Martel-Pelletier, Boulos Haraoui, Jean-Claude Tardif and Jean-Pierre Pelletier
Affiliation:
Keywords:
Cardiovascular disease, inflammation, biologics, TNF-alpha, IL-1, IL-6, cytokines, atherosclerosis, heart failure
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.
