A potentially interesting idea is whether by controlling inflammation in autoimmune diseases you can prevent heart disease. The theory is that in certain individuals with coronary artery disease inflammation within the artery wall eventually causes blockage of coronary arteries and eventually heart attacks. Since people with autoimmune diseases have too much inflammation, and they also have somewhat higher rates of heart disease, potentially treating that inflammation could help prevent heart attacks in these people. The evidence showing this hasn’t been clear in the past. However a recent article published in the dermatology literature suggests that this phenomenon may in fact occur. Looking at a large number of patients with psoriasis or psoriatic arthritis, this study shows that treatment with TNF blockers or any other systemic treatment can lower the rate of heart disease compared to topical cream therapy for psoriasis alone. In addition there was a trend that the TNF blockers might do a better job of this risk reduction compared to other treatments, although that was not definitive in this study.
While I don’t think using TNF blockers should be thought of as a definitive method for reducing heart disease, it is reassuring to see that reducing inflammation in these individuals has potentially additional long term benefits. We know that various autoimmune diseases, for various reasons, increase the rate of heart disease long term. Considering that the available treatments for various autoimmune diseases have dramatically improved the last 10 years, we need to be more concerned how we prevent some of these other longer term problems.