Recent research on the use of tumor necrosis factor (TNF) inhibitors in treating ankylosing spondylitis (AS) has revealed conflicting results regarding their impact on heart health.
Early Use of TNF Inhibitors Linked to Higher Heart Risk
One major study suggests that starting TNF inhibitors early in treatment could increase the risk of cardiovascular disease (CVD). The study, which involved over 17,000 veterans with AS, found that patients who began TNF inhibitor therapy early faced a 17% higher chance of developing CVD and a 22% higher risk of major cardiovascular events, compared to those who started treatment later. Dr. Jean Liew, the lead investigator, expressed surprise at these results, as initial expectations were that TNF inhibitors would lower cardiovascular risk by reducing inflammation.
Potential Cardioprotective Effects of TNF Inhibitors
In contrast, other studies indicate that TNF inhibitors may offer some protection against heart disease. A recent analysis found that patients with radiographic axial spondyloarthritis, a form of AS, who were treated with TNF inhibitors had a lower risk of cardiovascular issues compared to those who did not receive the treatment. This study emphasized the importance of managing cardiovascular risk factors in patients with AS. Additionally, another study showed that patients using TNF inhibitors experienced fewer cardiovascular events than those not treated with biological disease-modifying antirheumatic drugs (bDMARDs), such as IL-17 inhibitors.
What This Means for Patients and Doctors
These mixed findings highlight the challenges of managing cardiovascular health in patients with AS. While early use of TNF inhibitors may be linked to an increased risk of heart problems, long-term treatment with these drugs appears to offer some protective benefits against CVD in certain cases. The differences in results could be influenced by factors such as disease activity and patient characteristics, suggesting that more research is needed to better understand the relationship between TNF inhibitors and cardiovascular health in AS patients.
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