SynthesisArthritis care & research2020
Comparative Risk of Cardiovascular Events With Biologic and Synthetic Disease-Modifying Antirheumatic Drugs in Patients With Rheumatoid Arthritis: A Systematic Review and Meta-Analysis.
Synthesis in Arthritis care & research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 84 papers, 5 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
84 citing papers in PubMed, 5 syntheses or guidelines pooled it, 148 citations in OpenAlex.
- Systemic Therapy for Atopic Dermatitis in Children and Adolescents: A US Expert Consensus.Dermatology (Basel, Switzerland) · 2024Guideline
- Vascular effects of biologic and targeted synthetic antirheumatic drugs approved for rheumatoid arthritis: a systematic review.Clinical rheumatology · 2023Pooled it
- Genetic Liability to Rheumatoid Arthritis in Relation to Coronary Artery Disease and Stroke Risk.Arthritis & rheumatology (Hoboken, N.J.) · 2022Pooled it
- Safety of baricitinib for the treatment of rheumatoid arthritis over a median of 4.6 and up to 9.3 years of treatment: final results from long-term extension study and integrated database.Annals of the rheumatic diseases · 2022Pooled it
- Effect of disease modifying anti-rheumatic drugs on major cardiovascular events: a meta-analysis of randomized controlled trials.Scientific reports · 2021Pooled it
- Impaired coagulation parameters in early RA are restored by effective antirheumatic therapy: a prospective pilot study.RMD open · 2024Trial
- Impact of RA treatment strategies on lipids and vascular inflammation in rheumatoid arthritis: a secondary analysis of the TARGET randomized active comparator trial.Arthritis research & therapy · 2024Trial
- Risk of major adverse cardiovascular events with tofacitinib versus tumour necrosis factor inhibitors in patients with rheumatoid arthritis with or without a history of atherosclerotic cardiovascular disease: a post hoc analysis from ORAL Surveillance.Annals of the rheumatic diseases · 2023Trial
- Metabolic challenges in rheumatoid arthritis: a translational overview from pathogenesis to patient care.Acta diabetologica · 2026Review
- [Giant cell arteritis: when to use tocilizumab, when to use upadacitinib].Zeitschrift fur Rheumatologie · 2026Article
- Inflammation in atherosclerosis: Drivers, mechanisms and therapies.Acta pharmaceutica Sinica. B · 2026Review
- Article
- Safety of Biologic and Targeted Synthetic Disease-Modifying Antirheumatic Drugs in Rheumatoid Arthritis: A Longitudinal Analysis.Drug safety · 2026Article
- [Cardiovascular risk in inflammatory rheumatic diseases : Evidence-based strategies for risk reduction in rheumatologic practice].Zeitschrift fur Rheumatologie · 2026Review
- Stroke in autoimmune rheumatic diseases.Rheumatology international · 2026Review
- [Consensus statement of the Austrian Society for Rheumatology and Rehabilitation on the management of increased cardiovascular risk in rheumatoid arthritis, psoriatic arthritis and spondyloarthritis].Wiener klinische Wochenschrift · 2026Article
- Heart Failure in Rheumatoid Arthritis: Epidemiology, Pathogenesis, Diagnosis, Treatment, and Emerging Insights-A Comprehensive Review.Medicina (Kaunas, Lithuania) · 2026Review
- What to do when the first TNF inhibitor fails in rheumatoid arthritis: stratified expert recommendations from a scoping review and Delphi consensus.Therapeutic advances in musculoskeletal disease · 2026Article
- Metabolic Consequences of Rheumatoid Arthritis.Arthritis care & research · 2025Review
- A Comprehensive Review: Unraveling the Role of Inflammation in the Etiology of Heart Failure.Heart failure reviews · 2025Review
24 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 5 institutions in 2 countries.
Funding
Abstract
objectiveWe performed a systematic review and meta-analysis to evaluate the comparative effects of tumor necrosis factor inhibitors (TNFi), non-TNFi biologics, and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) on cardiovascular risk in rheumatoid arthritis (RA).
methodsUsing a systematic search through May 8, 2018, we included 14 observational studies in adults with RA treated with TNFi, non-TNFi biologics, tofacitinib, or csDMARDs, reporting the risk of major adverse cardiovascular events (MACE) or stroke. Only studies reporting active comparators were included. We performed random effects meta-analysis and estimated odds ratios (ORs) and 95% confidence intervals (95% CIs).
resultsAs compared to TNFi, tocilizumab was associated with a decreased risk of MACE (OR 0.59 [95% CI 0.34-1.00]), whereas csDMARDs were associated with an increased risk of MACE (csDMARDs including methotrexate OR 1.45 [95% CI 1.09-1.93]; without methotrexate OR 2.57 [95% CI 1.32-5.00]), without heterogeneity (I
conclusionBased on meta-analysis, as compared to TNFi, tocilizumab may be associated with a reduced risk of MACE, whereas csDMARDs may be associated with an increased risk of MACE and stroke.
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What OpenQuestion holds
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.