Do TNF Inhibitors Directly Affect Cardiovascular Risk?

Patients with rheumatoid arthritis (RA) are at excess risk for cardiovascular (CV) complications, especially coronary heart disease. This risk is explained only partially by traditional risk factors. Treating RA patients with tumor-necrosis factor (TNF) inhibitors lowers risk for coronary heart disease; but whether the diminished CV risk is a direct effect of TNF inhibitors on CV inflammation or an indirect effect associated with better RA control is unclear. In this Swedish case-control study, researchers evaluated 6864 patients who started TNF inhibitors to determine response to therapy at 5 months after drug initiation (RA disease control) and incidence of acute coronary syndrome (ACS) within 2 years. Each patient was matched by age, sex…