The role of disease-modifying anti-rheumatic drugs (DMARDs) in cardiovascular risk management induced by rheumatoid arthritis.

Rheumatoid arthritis (RA) is a prevalent autoimmune disease affecting approximately 1% of the global population, which significantly increases the risks of cardiovascular disease (CVD). RA-associated cardiovascular risks, such as pericarditis, myocarditis, heart failure, myocardial infarction, arrhythmias, atherosclerosis, and endothelial dysfunction, are major contributors to mortality in RA patients. These risks are driven by a complex interplay of chronic immune-inflammatory activation, metabolic dysregulation, genetic factors, and the adverse effects of long-term drug therapy. Despite advances in understanding the mechanisms of CVD in RA and their interplay with traditional risk factors, optimal approaches for risk management in this patient population are not yet well-defined. Cardiovascular risk assessment in RA patients requires regular monitoring of traditional risk factors and disease activity, supplemented by emerging biomarkers and imaging techniques. Disease-modifying anti-rheumatic drugs (DMARDs) are central to managing both RA and cardiovascular risks. The potential role of cell therapy in cardiovascular risk management induced by RA also is discussed. Despite progress in understanding RA-related cardiovascular risks, challenges remain in predicting patient outcomes. Future research should focus on identifying novel biomarkers for early detection, developing personalized management strategies, and evaluating the long-term effects of immunomodulatory therapies on cardiovascular risks.