title: 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.affiliation: Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Notre-Dame Hospital, 1560 Sherbrooke Street East, Montreal, Quebec, Canada. camille.roubille@gmail.com
authors.forename: Camille
authors.initials: C
authors.lastname: Roubille
authors.forename: Johanne
authors.initials: J
authors.lastname: Martel-Pelletier
authors.forename: Boulos
authors.initials: B
authors.lastname: Haraoui
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Tardif
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Pelletier
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000628:therapy; D002318:Cardiovascular Diseases / Q000628:therapy*; D002319:Cardiovascular System / Q000187:drug effects; D002986:Clinical Trials as Topic; D006801:Humans; D007375:Interleukin-1 / Q000276:immunology; D015850:Interleukin-6 / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*; D014657:Vasculitis / Q000628:therapy
chemical_list: D000911:Antibodies, Monoclonal; D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha