Table 5

Years of exposure to disease-modifying antirheumatic drugs and cardiovascular morbidity in patients with rheumatoid arthritis in the QUEST-RA study


HRa (95% CI) CV all types
HRb (95% CI) CV all types
HRc (95% CI)







CV all types
Myocardial infarction
Stroke

Methotrexate
0.82 (0.79–0.86)d
0.84 (0.80–0.87)d
0.85 (0.81–0.89)d
0.82 (0.74–0.91)d
0.89 (0.82–0.98)e
Glucocorticoids
0.94 (0.92–0.97)d
0.95 (0.93–0.97)d
0.95 (0.92–0.98)d
0.96 (0.91–1.00)
0.98 (0.93–1.03)
Antimalarials
0.94 (0.91–0.98)f
0.95 (0.91–0.99)f
0.98 (0.94–1.02)
0.94 (0.85–1.03)
0.87 (0.76–1.01)
Sulfasalazine
0.91 (0.87–0.96)d
0.92 (0.88–0.97)f
0.92 (0.87–0.98)f
0.82 (0.69–0.98)e
0.90 (0.79–1.03)
Gold
0.96 (0.92–1.00)e
0.96 (0.92–1.00)e
0.99 (0.95–1.03)
1.04 (0.98–1.10)
0.98 (0.89–1.07)
Leflunomide
0.52 (0.38–0.72)d
0.55 (0.41–0.75)d
0.59 (0.43–0.79)f
0.52 (0.26–1.06)
0.91 (0.65–1.28)
TNF-α blockers
0.67 (0.53–0.85)f
0.71 (0.56–0.89)f
0.64 (0.49–0.83)f
0.42 (0.21–0.81)e
0.64 (0.39–1.05)

aCrude hazard ratio. bAdjusted hazard ratio by age and gender. cAdjusted hazard ratio by age, gender, disease activity/severity (DAS 28 [disease activity score using 28 joint counts] and Health Assessment Questionnaire), rheumatoid arthritis characteristics (rheumatoid factor-positive and extra-articular manifestations), and traditional cardiovascular risk factors (hypertension, hyperlipidemia, diabetes, smoking ever, and obesity). dP < 0.001. eP < 0.05. fP < 0.01. CI, confidence interval; CV, cardiovascular; QUEST-RA, Questionnaires in Standard Monitoring of Patients with Rheumatoid Arthritis; TNF-α, tumor necrosis factor-alpha.

Naranjo et al. Arthritis Research & Therapy 2008 10:R30   doi:10.1186/ar2383