Biologic Disease-Modifying Antirheumatic Drugs (DMARDs)
Özet
The heart is often affected in rheumatic diseases due to the direct effect of the disease, accelerated atherosclerosis or side effects of the pharmacological agents used for the treatment. Biologic disease-modifying antirheumatic drugs (bDMARDs) are widely used for disease control in rheumatic diseases. Biologic DMARDs encompass a range of therapeutic agents, including tumour necrosis factor (TNF) inhibitors, interleukin-6 (IL-6) inhibitors, B-cell depletion therapies and B-cell activation inhibitors, co-stimulation blockers, IL-17 inhibitors, IL-12/23 inhibitors, and IL-1 inhibitors. Disease activity control in rheumatic diseases is important in terms of reducing the risk of cardiovascular disease. Biologic DMARDs are efficacious in disease control; however, they may precipitate cardiovascualar complications. Clinicians should be aware of the cardiovascular side effects of these drugs and perform preventive measures in patients with increased cardiovascular risk.
Romatizmal hastalıklarda kalp, hastalığın doğrudan etkisi, hızlanmış ateroskleroz veya tedavi için kullanılan farmakolojik ajanların yan etkileri nedeniyle sıklıkla etkilenmektedir. Biyolojik hastalık modifiye edici antiromatizmal ilaçlar (bDMARD'lar) romatizmal hastalıklarda hastalık kontrolü için yaygın olarak kullanılmaktadır. Biyolojik DMARD'lar, tümör nekroz faktörü (TNF) inhibitörleri, interlökin-6 (IL-6) inhibitörleri, B-hücresi deplesyon tedavileri ve B-hücresi aktivasyon inhibitörleri, ko-stimülasyon blokerleri, IL-17 inhibitörleri, IL-12/23 inhibitörleri ve IL-1 inhibitörleri dahil olmak üzere bir dizi terapötik ajanı kapsamaktadır. Romatizmal hastalıklarda hastalık aktivitesinin kontrolü kardiyovasküler hastalık riskinin azaltılması açısından önemlidir. Biyolojik DMARD'lar hastalık kontrolünde etkilidir; ancak kardiyovasküler komplikasyonları tetikleyebilirler. Klinisyenler bu ilaçların kardiyovasküler yan etkilerinin farkında olmalı ve artmış kardiyovasküler riski olan hastalarda önleyici tedbirler almalıdır.
Referanslar
Baniaamam M, Handoko M L, Agca R, et al. The Effect of Anti-TNF Therapy on Cardiac Function in Rheumatoid Arthritis: An Observational Study. Journal of Clinical Medicine. 2020;9(10):3145. doi: 10.3390/jcm9103145.
Provan S A, Lillegraven S, Sexton J, et al. Trends in all-cause and cardiovascular mortality in patients with incident rheumatoid arthritis: a 20-year follow-up matched case-cohort study. Rheumatology.2020;59(3):505–512. doi: 10.1093/rheumatology/kez371.
Liu Y, Kaplan M J. Cardiovascular disease in systemic lupus erythematosus: an update. Current Opinion in Rheumatology. 2018;30(5):441–448. doi: 10.1097/BOR.0000000000000528.
Agca R, Heslinga SC, S Rollefstad S et al. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Annals of Rheumatic Diseases. 2017;76(1):17-28. doi: 10.1136/annrheumdis-2016-209775.
Avouac J, Allanore Y. Cardiovascular risk in rheumatoid arthritis: effects of anti-TNF drugs. Expert Opinion on Pharmacotherapy. 2008;9(7):1121-8. doi: 10.1517/14656566.9.7.1121.
Barnabe C, Martin B J, Ghali W A. Systematic review and meta-analysis: anti-tumor necrosis factor α therapy and cardiovascular events in rheumatoid arthritis. Arthritis Care Research (Hoboken). 2011;63(4):522-9. doi: 10.1002/acr.20371.
Anker SD, Coats AJ. How to RECOVER from RENAISSANCE? The significance of the results of RECOVER, RENAISSANCE, RENEWAL and ATTACH. International Journal of Cardiology. 2002;86:123–30. doi: 10.1016/s0167-5273(02)00470-9.
Coletta AP, Clark AL, Banarjee P, et al. RENEWAL (RENAISSANCE and RECOVER) and ATTACH. European Journal of Heart Failure. 2002;4:559–61. doi: 10.1016/s1388-9842(02)00121-6..
Mann DL, McMurray JJV, Packer M, et al. Targeted anticytokine therapy in patients with chronic heart failure. Results of the randomized etanercept worldwide evaluation (RENEWAL). Circulation. 2004;109:1594–602. doi: 10.1161/01.CIR.0000124490.27666.B2.
Chung E S, Packer M, Lo K H et al. Randomized, double-blind, placebo-controlled, pilot trial of infliximab, a chimeric monoclonal antibody to tumor necrosis factor-alpha, in patients with moderate-to-severe heart failure: results of the anti-TNF Therapy Against Congestive Heart Failure (ATTACH) trial. Circulation. 2003; 107(25):3133-40. doi: 10.1161/01.CIR.0000077913.60364.D2.
Cacciapaglia F, Navarini L, Menna P, et al. Cardiovascular safety of anti-TNF-alpha therapies: facts and unsettled issues. Autoimmunity Reviews. 2011;10(10):631-5. doi: 10.1016/j.autrev.2011.04.014.
Kwon HJ, Coté TR, Cuffe MS, et al. Case reports of heart failure after therapy with a tumor necrosis factor antagonist. Annals of Internal Medicine. 2003; 138:807. doi: 10.7326/0003-4819-138-10-200305200-00008.
Wolfe F, Michaud K. Heart failure in rheumatoid arthritis: rates, predictors, and the effect of anti-tumor necrosis factor therapy. The American Journal of Medicine. 2004; 116:305-11. doi: 10.1016/j.amjmed.2003.09.039.
Solomon DH, Rassen JA, Kuriya B, et al. Heart failure risk among patients with rheumatoid arthritis starting a TNF antagonist. Annals of the Rheumatic Diseases. 2013; 72(11):1813-8. doi: 10.1136/annrheumdis-2012-202136.
Toufaily A. Severe cardiomyopathy induced by Adalimumab administration for Crohn’s disease. Journal of Cardiology Case Reports. 2020.doi: 10.15761/JCCR.1000129.
Ozkan, H, Cetinkaya A S, Yildiz T, et al. A Rare Side Effect due to TNF-Alpha Blocking Agent: Acute Pleuropericarditis with Adalimumab. Case Reports in Rheumatology. 2013; 2013: 985914. doi: 10.1155/2013/985914.
Smolen JS, Beaulieu A, Rubbert-Roth, et al. Effect of interleukin-6 receptor inhibition with tocilizumab in patients with rheumatoid arthritis (OPTION study): a double-blind, placebo-controlled, randomised trial. The Lancet. 2008;371:987–997. doi: 10.1016/S0140-6736(08)60453-5.
Gabay C, Emery P, van Vollenhoven R, et al. Tocilizumab monotherapy versus adalimumab monotherapy for treatment of rheumatoid arthritis (ADACTA): a randomised, double-blind, controlled phase 4 trial. The Lancet. 2013;381:1541–1550. doi: 10.1016/S0140-6736(13)60250-0.
Castagné B, Viprey M, Martin J, et al. Cardiovascular safety of tocilizumab: A systematic review and network meta-analysis. PLoS One. 2019; 14(8): e0220178. doi: 10.1371/journal.pone.0220178.
Rao V U, Pavlov A, Klearman M, et al. An evaluation of risk factors for major adverse cardiovascular events during tocilizumab therapy. Arthritis Rheumatology. 2015;67(2):372-80. doi: 10.1002/art.38920.
Miyahara D, Moriyama Y, Yamazaki Y et al. Cardiac Tamponade During Tocilizumab Therapy in a Patient with Rheumatoid Arthritis and Anti-DNA Antibody Positivity. Internal Medicine. 2021;60(20):3245-3249.doi: 10.2169/internalmedicine.7166-21.
Nozawa T, Imagawa T, Ito S. Coronary-Artery Aneurysm in Tocilizumab-Treated Children with Kawasaki's Disease. New England Journal of Medicine.2017;377(19):1894-1896. doi: 10.1056/NEJMc1709609.
Rituxan‑FDA Prescribing Information, Side Effects and Uses. Available from: http://www.drugs.com/pro/rituxan.html.
Foran J M, Rohatiner A Z, Cunningham D, et al. European phase II study of rituximab (chimeric anti-CD20 monoclonal antibody) for patients with newly diagnosed mantle-cell lymphoma and previously treated mantle-cell lymphoma, immunocytoma, and small B-cell lymphocytic lymphoma. Journal of Clinical Oncology. 2000;18(2):317-24. doi 10.1200/JCO.2000.18.2.317.
Poterucha JT, Westberg M, Nerheim P, et al. Rituximab‑induced polymorphic ventricular tachycardia. Texas Heart Institute Journal. 2010;37:218‑20.
Arai Y, Tadokoro J, Mitani K. Ventricular tachycardia associated with infusion of rituximab in mantle cell lymphoma. American Journal of Hematolology. 2005;78:317‑8. doi: 10.1002/ajh.20303
Patil V B, Lunge S B, Doshi B R. Cardiac side effect of rituximab. Indian Journal of Drugs in Dermatology. 2020;6(1):49-52.
Millward PM, Bandarenko N, Chang PP, et al. Cardiogenic shock complicates successful treatment of refractory thrombotic thrombocytopenia purpura with rituximab. Transfusion 2005;45:1481‑6. doi: 10.1111/j.1537-2995.2005.00560.x.
Kanamori H, Tsutsumi Y, Mori A, et al. Delayed reduction in left ventricular function following treatment of non‑Hodgkin’s lymphoma with chemotherapy and rituximab, unrelated to acute infusion reaction. Cardiology. 2006;105:184‑7. doi: 10.1159/000091416.
Mulay S, Boruchov A. Recurrent and partially reversible cardiomyopathy occurring during treatment with bendamustine and rituximab. Leukemia & Lymphoma. 2015;56:805‑7. doi: 10.3109/10428194.2014.931954.
Smith SA, Auseon AJ. Chemotherapy‑induced takotsubo cardiomyopathy. Heart Failure Clinics. 2013;9:233‑42. doi: 10.1016/j.hfc.2012.12.009.
van Vollenhoven R F, Emery P, Bingham C O et al. Longterm safety of patients receiving rituximab in rheumatoid arthritis clinical trials. The Journal of Rheumatolology. 2010;37(3):558-67. doi: 10.3899/jrheum.090856.
Tschöpe C, Van Linthout S, Spillmann F, et al. Targeting CD20+ B-lymphocytes in inflammatory dilated cardiomyopathy with rituximab improves clinical course: a case series. European Heart Journal Case Reports. 2019;3(3):131. doi: 10.1093/ehjcr/ytz131.
Zhang J, Xie F, Yun H, et al. Comparative effects of biologics on cardiovascular risk among older patients with rheumatoid arthritis. Annals of the Rheumatic Diseases. 2016;75:1813-8. doi: 10.1136/annrheumdis-2015-207870.
Jin Y, Kang E A, Brill G, et al. Cardiovascular (CV) Risk after Initiation of Abatacept versus TNF Inhibitors in Rheumatoid Arthritis Patients with and without Baseline CV Disease. The Journal of Rheumatolology. 2018;45(9):1240-1248. doi: 10.3899/jrheum.170926.
Puig L. Cardiometabolic Comorbidities in Psoriasis and Psoriatic Arthritis. International Journal of Molecular Sciences. 2018;19(1):58. doi: 10.3390/ijms19010058.
von Stebut E, Reich K, Thaçi D et al. Impact of Secukinumab on Endothelial Dysfunction and Other Cardiovascular Disease Parameters in Psoriasis Patients over 52 Weeks. Journal of Investigative Dermatology. 2019;139(5): 1054-1062. doi: 10.1016/j.jid.2018.10.042.
Inaba Y, Chen, J A, Bergmann S R. Prediction of future cardiovascular outcomes by flow-mediated vasodilatation of brachial artery: a meta-analysis. The International Journal of Cardiovascular Imaging. 2010; 26:631–640. doi: 10.1007/s10554-010-9616-1.
Vegas L P,Corvoisier P L, Penso L et al. Risk of major adverse cardiovascular events in patients initiating biologics/apremilast for psoriatic arthritis: a nationwide cohort study. Rheumatology (Oxford). 2022 Apr 11;61(4):1589-1599. doi: 10.1093/rheumatology/keab522.
Ritchlin C, Rahman P, Kavanaugh A et al. Efficacy and safety of the anti-IL-12/23 p40 monoclonal antibody, ustekinumab, in patients with active psoriatic arthritis despite conventional non-biological and biological anti-tumour necrosis factor therapy: 6-month and 1-year results of the phase 3, multicentre, double-blind, placebo-controlled, randomised PSUMMIT 2 trial. Annals of the Rheumatic Diseases. 201473(6):990-9. doi: 10.1136/annrheumdis-2013-204655.
Poizeau F, Nowak E, Kerbrat S et al. Association Between Early Severe Cardiovascular Events and the Initiation of Treatment With the Anti-Interleukin 12/23p40 Antibody Ustekinumab JAMA Dermatolology 2020;156(11):1208-1215. doi: 10.1001/jamadermatol.2020.2977.
Abdelnabi M, ElNawaa S, Benjanuwattra J et al.Ustekinumab-Induced Fatal Acute Heart Failure in a Young Female: A Case Report. Methodist Debakey Cardiovascular Journal. 2022;18(1): 54–58. doi: 10.14797/mdcvj.1076.
Buckley L F, Abbate A. Interleukin-1 blockade in cardiovascular diseases: a clinical update. European Heart Journal. 2018;39:2063–2069. doi: 10.1093/eurheartj/ehy128.
Ridker PM, Everett BM, Thuren T, et al. Antiinflammatory therapy with canakinumab for atherosclerotic disease. New England Journal of Medicine. 2017;377:1119–1131. doi: 10.1056/NEJMoa1707914.
Van Tassell BW, Arena RA, Toldo S, et al. Enhanced interleukin-1 activity contributes to exercise intolerance in patients with systolic heart failure. PLoS One. 2012;7:e33438. oi: 10.1371/journal.pone.0033438.
Van Tassell BW, Canada J, Carbone S, et al. Interleukin-1 blockade in recently decompensated systolic heart failure: results from the REcently Decompensated Heart failure Anakinra Response Trial (REDHART). Circulation: Heart Failure. 2017;10:e004373. oi: 10.1161/CIRCHEARTFAILURE.117.004373.
Klein A L, Imazio M, Cremer P et al. Phase 3 Trial of Interleukin-1 Trap Rilonacept in Recurrent Pericarditis. New England Journal of Medicine. 2021;384(1):31-41. doi: 10.1056/NEJMoa2027892
Jain S, Thongprayoon C, Espinosa RE, et al. Effectiveness and Safety of Anakinra for Management of Refractory Pericarditis. The American Journal of Cardiology. 2015;116(8):1277. doi: 10.1016/j.amjcard.2015.07.047.
