Rheumatoid arthritis (RA) is an inflammatory autoimmune disease. Patients with RA tend to die younger and largely from cardiovascular disease (CVD). A marker of inflammation is an elevation of the C-reactive protein (CRP) and has been shown to predict CVD.
Dr. Tracey M. Farragher, University of Manchester, wondered why other inflammatory diseases, like Crohn’s disease, do not share the same high risk of premature death from CVD. Her study focused on two genes associated with RA risk factors–HLA-DRB1 and PTPN22. The study involved 1,022 patients with inflammatory polyarthritis (IP) with a mean age of 54, at the onset of symptoms. By the completion of the study 24% of the patients had died. Of the patients who had died 31% had CVD listed as the cause of death.
Researchers found that individuals with the HLA-DRB1 combination had a 3-fold risk of death. Smokers were at a higher risk of death because of an interaction of smoking with certain genes. No evidence of any association between the PTPN22 gene and the risk of death was found.
This is the first study to link the HLA-DRB1 genotype with premature death from cardiovascular disease for those afflicted with any form of inflammatory arthritis. Farragher feels the study raises the possibility of a targeted strategy to prevent CVD in RA patients and reinforces the danger of smoking for anyone with arthritis.