Evidence map›Paper›PMID 25561362›Full record

SynthesisAnnals of the rheumatic diseases2015

The effects of tumour necrosis factor inhibitors, methotrexate, non-steroidal anti-inflammatory drugs and corticosteroids on cardiovascular events in rheumatoid arthritis, psoriasis and psoriatic arthritis: a systematic review and meta-analysis.

Camille Roubille, Vincent Richer, Tara Starnino, Collette McCourt, Alexandra McFarlane, Patrick Fleming, Stephanie Siu, John Kraft, Charles Lynde, Janet Pope and 6 more

Registry-linked trialOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Annals of the rheumatic diseases, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02709694 (Imaging Biomarkers in Crohn's Associated Spondyloarthritis), which is not on this map. Cited by 416 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
416citing papers in PubMed, 8 pooled it
68.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02709694 completednot on this mapstarted 2016, after this paper: background citation

Imaging Biomarkers in Crohn's Associated Spondyloarthritis

TypeobservationalSponsorHospital for Special Surgery, New YorkRan2016 to 2021Enrolled33ConditionsCrohn's Disease, SpondyloarthritisArmsNo intervention
3 · Its place in the literature

Who cites it

416 citing papers in PubMed, 8 syntheses or guidelines pooled it, 870 citations in OpenAlex.

  1. Major cardiovascular event risk of advanced therapies in inflammatory bowel diseases: systematic review and meta-analysis.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2026
    Pooled it
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  3. Guideline
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  5. Cardiovascular events risk in patients with systemic autoimmune diseases: a prognostic systematic review and meta-analysis.Clinical research in cardiology : official journal of the German Cardiac Society · 2024
    Pooled it
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  20. Biomarkers of Cardiovascular Stress: A Historical Review.Journal of cardiovascular development and disease · 2026
    Review

356 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 12 institutions in 1 country.

Camille RoubilleUniversity of Montreal Hospital Research Center (CRCHUM), Notre-Dame Hospital, Montreal, Quebec, Canada.
Vincent RicherDepartment of Medicine, Dermatology Service, St-Luc Hospital, Montreal, Quebec, Canada.
Tara StarninoSacré-Coeur Hospital of Montreal, University of Montreal, Montreal, Quebec, Canada.
Collette McCourtDepartment of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada.
Alexandra McFarlaneDivision of Rheumatology, University of Alberta, Edmonton, Alberta, Canada.
Patrick FlemingDivision of Dermatology, University of Toronto, Toronto, Ontario, Canada.
Stephanie SiuDivision of Rheumatology, Department of Medicine, Western University of Canada, St. Joseph's Health Care, London, Ontario, Canada.
John KraftLynde Dermatology, Markham, Ontario, Canada.
Charles LyndeLynde Dermatology, Markham, Ontario, Canada.
Janet PopeDivision of Rheumatology, Department of Medicine, Western University of Canada, St. Joseph's Health Care, London, Ontario, Canada.
Wayne GulliverFaculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.
Stephanie KeelingDivision of Rheumatology, University of Alberta, Edmonton, Alberta, Canada.
Jan DutzDepartment of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada.
Louis BessetteDepartment of Medicine, Centre de Recherche du CHU de Québec, Laval University, Quebec City, Quebec, Canada.
Robert BissonnetteInnovaderm Research, Montreal, Quebec, Canada.
Boulos HaraouiDepartment of Medicine, Rheumatic Disease Unit, Centre Hospitalier de l'Université de Montréal (CHUM) and Institut de Rhumatologie de Montréal, Montreal, Quebec, Canada.
Lynde Centre for Dermatology · CAUniversity of Alberta · CAUniversity of British Columbia · CAHôpital Notre-Dame · CAHôpital Saint-Luc · CAInnovaderm (Canada) · CAMemorial University of Newfoundland · CASt Joseph's Health Care · CAUniversité de Montréal · CAUniversité Laval · CAUniversity of Toronto · CAWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The objective of this systematic literature review was to determine the association between cardiovascular events (CVEs) and antirheumatic drugs in rheumatoid arthritis (RA) and psoriatic arthritis (PsA)/psoriasis (Pso). Systematic searches were performed of MEDLINE, EMBASE and Cochrane databases (1960 to December 2012) and proceedings from major relevant congresses (2010-2012) for controlled studies and randomised trials reporting confirmed CVEs in patients with RA or PsA/Pso treated with antirheumatic drugs. Random-effects meta-analyses were performed on extracted data. Out of 2630 references screened, 34 studies were included: 28 in RA and 6 in PsA/Pso. In RA, a reduced risk of all CVEs was reported with tumour necrosis factor inhibitors (relative risk (RR), 0.70; 95% CI 0.54 to 0.90; p=0.005) and methotrexate (RR, 0.72; 95% CI 0.57 to 0.91; p=0.007). Non-steroidal anti-inflammatory drugs (NSAIDs) increased the risk of all CVEs (RR, 1.18; 95% CI 1.01 to 1.38; p=0.04), which may have been specifically related to the effects of rofecoxib. Corticosteroids increased the risk of all CVEs (RR, 1.47; 95% CI 1.34 to 1.60; p<0.001). In PsA/Pso, systemic therapy decreased the risk of all CVEs (RR, 0.75; 95% CI 0.63 to 0.91; p=0.003). In RA, tumour necrosis factor inhibitors and methotrexate are associated with a decreased risk of all CVEs while corticosteroids and NSAIDs are associated with an increased risk. Targeting inflammation with tumour necrosis factor inhibitors or methotrexate may have positive cardiovascular effects in RA. In PsA/Pso, limited evidence suggests that systemic therapies are associated with a decrease in all CVE risk.

Indexed as

Adrenal Cortex HormonesAnti-Inflammatory Agents, Non-SteroidalAntirheumatic AgentsArthritis, PsoriaticArthritis, RheumatoidCardiovascular DiseasesHumansMethotrexatePsoriasisRisk FactorsTumor Necrosis Factor-alphaAdrenal Cortex HormonesAnti-Inflammatory Agents, Non-SteroidalAntirheumatic AgentsMethotrexateTumor Necrosis Factor-alpha

Identifiers

PMID25561362
PMCPMC4345910
OpenAlexW2169773326

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.