Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Clinical Reviews in Allergy & Immunology
Published in: Clinical Reviews in Allergy & Immunology 3/2017

01-06-2017

Cardiac Impairment in Rheumatoid Arthritis and Influence of Anti-TNFα Treatment

Authors: Ivica Lazúrová, Ľubomír Tomáš

Published in: Clinical Reviews in Allergy & Immunology | Issue 3/2017

Login to get access

Abstract

There is evidence that rheumatoid arthritis (RA) is associated with higher overall and cardiovascular (CV) morbidity and mortality as compared with general population. Increased prevalence of traditional risk factors and chronic inflammation, that has been recognized as independent CV risk factor, may play an important role in atherosclerosis and subsequently ischemic heart disease development. However, myocardial dysfunction as a result of chronic inflammation and secondarily myocardial fibrosis markedly participates on heart failure development. Proinflammatory cytokines, such as C-reactive protein, tumor necrosis factor alpha (TNFα), interleukins 1 and 6, that are markedly increased in RA, play a role in the acceleration of atherosclerosis as well as myocardial fibrosis development. Several studies documented that increased CV risk was associated with seropositivity, disease activity score, citrullination, and duration of RA. Early detection of heart dysfunction is based on echocardiographic detection of diastolic dysfunction resulting from myocardial inflammation and fibrosis. Some studies showed also higher prevalence of left ventricular systolic dysfunction and increased prevalence of cardiac arrhythmias as compared to non-RA population. There are still controversies on the impact of NT-proBNP in predicting cardiac impairment in RA patients. Some authors consider it to be a sensitive noninvasive predictor of subclinical CV disease in these patients and also a predictor of all-cause mortality independently on traditional CV risk factors. However, the correlation with parameters of cardiac function was confirmed only in a few studies. The impact of biological treatment on progression of atherosclerosis and heart failure is still controversial and seems to be not harmful in young patients with normal left ventricular function. The effect of biologics, especially anti-TNFα drugs, is probably related to the cardiac function before treatment. Larger prospective clinical, echocardiographic, and magnetic resonance studies are needed.
Literature
1.
Alamanos Y, Drosos AA (2005) Epidemiology of adult rheumatoid arthritis. Autoimmun Rev 4(3):130–136CrossRefPubMed
2.
Norton S, Sacker A, Dixey J, Done J, Williams P, Young A (2013) Early rheumatoid arthritis study. Trajectories of functional limitation in early rheumatoid arthritis and their association with mortality. Rheumatology (Oxford) 52(11):2016–2024CrossRef
3.
Schuett KA, Lehrke M, Marx N, Burgmaier M (2015) High risk cardiovascular patients: clinical features, comorbidities and interconnecting mechanisms. Front Immunol 6:1–9CrossRef
4.
Young A, Koduri G, Batley M, Kulinskaya E, Gough A, Norton S et al (2007) Mortality in rheumatoid arthritis. Increased in the early course of disease, in ischaemic heart disease and in pulmonary fibrosis. Rheumatol (Oxford) 46(2):350–357CrossRef
5.
Wallberg-Johnsson S, Ohman ML, Dahlqvist SR (1997) Cardiovascular morbidity and mortality in patients with seropositive rheumatoid arthritis in northern Sweden. J Rheumatol 24:445–451
6.
Ajeganova S, Humphreys JH, Verheul MK, van Steenbergen HW, van Nies JA, Hafstrom I et al. (2016) Anticitrullinated protein antibodies and rheumatoid factor are associated with increased mortality but different cause of death in patients with rheumatoid arthritis: a longitudinal study in three European cohort. Ann Rheum Dis. doi: 10.​1136/​annrheumdis-2015-208579.
7.
8.
9.
Maradit-Kremers H, Nicola PJ, Crowson CS, Ballman KV, Gabriel SE (2004) Prognostic importance of low body mass index in relation to cardiovascular mortality in rheumatoid arthritis. Arthritis Rheumatism 50:3450–3456CrossRef
10.
Maradit-Kremers H, Crowson CS, Nicola PJ, Ballman KV, Roger VL, Jacobsen SJ, Gabriel SE (2005) Increased unrecognized coronary heart disease and sudden death in rheumatoid arthritis. Arthritis Rheum 52:402–410CrossRefPubMed
11.
Kobayashi H, Giles JT, Polak JF, Blumenthal RS, Leffell MS, Szklo M et al (2010) Increased prevalence of carotid artery atherosclerosis in rheumatoid arthritis is artery specific. J Rheumatol 37:730–739CrossRefPubMed
12.
Giles JT, Fernandes V, Lima JAC, Bathon JM (2005) Myocardial dysfunction in rheumatoid arthritis: epidemiology and pathogenesis. Arthritis Res Ther 7:195–207CrossRefPubMedPubMedCentral
13.
Ntusi NA, Piechnik SK, Francis JM, Ferreira VM, Matthews PM, Robson MD et al (2015) Diffuse myocardial fibrosis and inflammation in rheumatoid arthritis: insights from CMR T1 mapping. JACC Cardiovasc Imaging 8(5):526–536CrossRefPubMed
14.
Rodriguez-Rodriguez L, Lopez-Mejias R, Fernandez-Gutierez B, Balsa A, Gonzales-Gay MA, Martin J (2015) Rheumatoid arthritis: genetic variants as biomarkers of cardiovascular disease. Curr Pharm Des 21(2):182–201CrossRefPubMed
15.
Kumar N, Marshall NJ, Hammal DM, Pearce MS, Parker L, Furniss SS et al (2007) Causes of death in patients with rheumatoid arthritis: comparison with siblings and matched osteoarthritis controls. J Rheumatol 34:1695–1698PubMed
16.
Wolfe F, Michaud K (2004) Heart failure in rheumatoid arthritis: rates, predictors and the effects of anti tumor necrosis factor therapy. Am J Med 116:305–311CrossRefPubMed
17.
18.
Rostom S, Mengat M, Lahlou R, Hari A, Bahim R, Hassouni NH (2013) Metabolic syndrome in rheumatoid arthritis: case control study. BMC Musculosceletal Dis 14:147CrossRef
19.
Parra-Salcedo F, Contreras-Yáñez I, Elías-López D, Aguilar-Salinas CA, Pascual-Ramos V (2015) Prevalence, incidence and characteristics of the metabolic syndrome (MetS) in a cohort of Mexican Mestizo early rheumatoid arthritis patients treated with conventional disease modifying anti-rheumatic drugs: the complex relationship between MetS and disease activity. Arthritis Res Ther 17:34. doi:10.​1186/​s13075-015-0549-x CrossRefPubMedPubMedCentral
20.
21.
22.
Jiang P, Li H, Li X (2015) Diabetes mellitus risk factors in rheumatoid arthritis: a systematic review and meta-analysis. Clin Exp Rheumatol 33:115–121PubMed
23.
24.
25.
26.
Gabriel SE, Crowson CS, O’Fallon WM (1999) Comorbidity in arthritis. J Rheumatol 26:2475–2479PubMed
27.
Dessein PH, Stanwix AE, Joffe BI (2002) Cardiovascular risk in rheumatoid arthritis versus osteoarthritis: acute phase response related decreased insulin sensitivity and high-density lipoprotein cholesterol as well as clustering of metabolic syndrome features in rheumatoid arthritis. Arthritis Res 4(5):R5CrossRefPubMedPubMedCentral
28.
Solomon DH, Karlson EW, Rimm EB, Cannuscio CC, Mandl LA, Manson JE et al (2003) Cardiovascular morbidity and mortality in women diagnosed with rheumatoid arthritis. Circulation 107(9):1303–1309CrossRefPubMed
29.
Yang X, Gao F, Liu Y (2015) Association of homocysteine with immunological-inflammatory and metabolic laboratory markers and factors in relation to hyperhomocysteinaemia in rheumatoid arthritis. Clin Exp Rheumatol 33(6):900–903PubMed
30.
Hamamoto K, Yamada S, Yasumoto M, Yoda M, Yoda K, Tsuda A et al (2016) Association of nocturnal hypertension with disease activity in rheumatoid arthritis. Am J Hypertens 29(3):340–347. doi:10.​1093/​ajh/​hpv119 PubMed
31.
Zhao Q, Hong D, Zhang Y, Sang Y, Yang Z, Zhang X (2015) Association between anti-TNF therapy for rheumatoid arthritis and hypertension: a meta-analysis of randomized controlled trials. Medicine (Baltimore) 94(14):e731. doi:10.​1097/​MD.​0000000000000731​ CrossRef
32.
Jonsson SW, Backman C, Johnson O, Karp K, Lundstrom E, Sundqvist KG, Dahlqvist SR (2011) Increased prevalence of atherosclerosis in patients with medium term rheumatoid arthritis. J Rheumatol 28:2597–2602
33.
Sakai R, Hirano F, Kihara M, Yokoyama W, Yamazaki H, Harada S et al (2015) High prevalence of cardiovascular comorbidities in patients with rheumatoid arthritis from a population-based cross-sectional study of a Japanese health insurance database. Mod Rheumatol 14:1–7
34.
Myasoedova E, Gabriel SE, Green AB, Matteson EL, Crowson CS (2013) Impact of statin use on lipid levels in statin-naive patients with rheumatoid arthritis versus non-rheumatoid arthritis subjects: results from a population-based study. Arthritis Care Res (Hoboken) 65(10):1592–1599
35.
Provan SA, Semb AG, Hisdal J, Stranden E, Aqewall S, Dagfinud H et al (2011) Remission is the goal for cardiovascular risk management in patients with rheumatoid arthritis: a cross-sectional comparative study. Ann Rheum Dis 70:812–817CrossRefPubMed
36.
Hurt-Camejo E, Paredes S, Masana L, Camejo G, Sartipy P, Rosengren B et al (2001) Elevated levels of small, low-density lipoprotein with high affinity for arterial matrix components in patients with rheumatoid arthritis: possible contribution of phospholipase A2 to this atherogenic profile. Arthritis Rheum 44:2761–2767CrossRefPubMed
37.
Chavan VU, Ramavataram D, Patel PA, Rupani MP (2015) Evaluation of serum magnesium, lipid profile and various biochemical parameters as risk factors of cardiovascular diseases in patients with rheumatoid arthritis. J Clin Diagn Res 9(4):BC01–BC05PubMedPubMedCentral
38.
Liao KP, Liu J, Lu B, Solomon DH, Kim SC (2015) Association between lipid levels and major adverse cardiovascular events in rheumatoid arthritis compared to non-rheumatoid arthritis patients. Arthritis Rheumatol 67(8):2004–2010CrossRefPubMedPubMedCentral
39.
Södergren A, Karp K, Bengtsson C, Möller B, Rantapää-Dahlqvist S, Wållberg-Jonsson S (2015) The extent of subclinical atherosclerosis is partially predicted by the inflammatory load: a prospective study over 5 years in patients with rheumatoid arthritis and matched controls. J Rheumatol 42(6):935–942CrossRefPubMed
40.
Ahmed A, Hollan I, Curran SA, Kitson SM, Riggio MP, Mikkelsen K et al. (2016) Rheumatoid arthritis patients have a pro-atherogenic cytokine microenvironment in the aortic adventitia. Arthritis Rheumatol. doi: 10.​1002/​art.​39574
41.
del Rincón I, Polak JF, O’Leary DH, Battafarano DF, Erikson JM, Restrepo JF et al (2015) Systemic inflammation and cardiovascular risk factors predict rapid progression of atherosclerosis in rheumatoid arthritis. Ann Rheum Dis 74(6):1118–1123CrossRefPubMed
42.
43.
Maijer KI, Neumann E, Müller-Lander U, Drop DACAD, Ramwadhdoeve TH, Choi IYK et al (2015) Serum Vaspin levels are associated with the development of clinically manifest arthritis in autoantibody-positive individuals. PLoS One 10(12):e0144932CrossRefPubMedPubMedCentral
44.
Nicola PJ, Crowson CS, Maradit-Kremers H, Ballman KV, Roger VL, Jacobsen SJ, Gabriel SE (2006) Contribution of congestive heart failure and ischemic heart disease to excess mortality in rheumatoid arthritis. Arthritis Rheum 54(1):60–67CrossRefPubMed
45.
Nicola PJ, Maradit-Kremers H, Roger VL, Jacobsen SJ, Crowson CS, Ballman KV, Gabriel SE (2005) The risk of congestive heart failure in rheumatoid arthritis: a population-based study over 46 years. Arthritis Rheum 52(2):412–420CrossRefPubMed
46.
Schau T, Gottwald M, Arbach O, Seifert M, Schopp M, Neuss M et al (2015) Increased prevalence of diastolic heart failure in patients with rheumatoid arthritis correlates with active disease, but not with treatment type. J Rheumatol 42:2029–2037CrossRefPubMed
47.
Guedes C, Bianchi-Fior P, Cormier B, Barthelemy B, Rat AC, Boissier MC (2001) Cardiac manifestation of rheumatoid arthritis: a case-control transesophageal echocardiography study in 30 patients. Arthritis Rheum 45(2):129–135CrossRefPubMed
48.
Myasoedova E, Crowson CS, Nicola PJ, Maradit-Kremers H, Davis JM 3rd, Roger VL et al (2011) The influence of rheumatoid arthritis disease characteristics on heart failure. J Rheumatol 38(8):1601–1606CrossRefPubMedPubMedCentral
49.
Listing J, Strangfeld A, Kekow J, Schneider M, Kapelle A, Wassenberg S, Zink A (2008) Does tumor necrosis factor-α inhibition promote or prevent heart failure in patients with rheumatoid arthritis? Arthritis Rheum 58:667–677CrossRefPubMed
50.
Sarzi-Puttini P, Atzueni F, Doria A, Iaccarino L, Turiel M (2005) Tumor necrosis factor-alpha, biologic agents and cardiovascular risk. Lupus 14(9):780–784CrossRefPubMed
51.
Roldan AC, DeLong C, Qualls CR, Crawford MC (2007) Characterization of valvular heart disease in rheumatoid arthritis by transesophageal echocardiography and clinical correlates. Am J Cardiol 100:496–502CrossRefPubMed
52.
Giles JT, Fert-Bober J, Park JK, Bingham CO 3rd, Andrade F, Fox-Talbot K et al (2012) Myocardial citrullination in rheumatoid arthritis: a correlative histopathologic study. Arthritis Res Ther 14:R39CrossRefPubMedPubMedCentral
53.
Di Franco M, Paradiso M, Mammarella A, Paoletti V, Labbadia G, Coppotelli L et al (2000) Diastolic function abnormalities in rheumatoid arthritis. Evaluation by echo Doppler transmitral flow and pulmonary venous flow: relation with duration of disease. Ann Rheum Dis 59:227–229CrossRefPubMed
54.
Liang KP, Myasoedova E, Crowson CS, Davis JM, Roger VL, Karon BL et al (2010) Increased prevalence of diastolic dysfunction in rheumatoid arthritis. Ann Rheum Dis 69(9):1665–1670CrossRefPubMedPubMedCentral
55.
Tomáš L, Lazúrová I, Oetterová M, Pundová L, Petrášová D, Studenčan M (2013) Left ventricular morphology and function in patients with rheumatoid arthritis. Wien Klin Wochenschr 125(9-10):233–238CrossRefPubMed
56.
57.
Bhatia GS, Sosin MD, Patel JV, Grindulis KA, Khattak FH, Huighes EA et al (2006) Left ventricular systolic dysfunction in rheumatoid disease. An unrecognized burden? J Am Coll Cardiol 47:1169–1174CrossRefPubMed
58.
Cioffi G, Viapiana O, Ognibeni F, Dalbeni A, Gatti D, Adami S et al (2015) Prevalence and factors related to left ventricular systolic dysfunction in asymptomatic patients with rheumatoid arthritis. A prospective tissue Doppler echocardiography study. Herz 40(7):989–996CrossRefPubMed
59.
Lazzerini PE, Capecchi PL, Acampa M, Galeazzi M, Laghi-Pasini F (2014) Arrhythmic risk in rheumatoid arthritis: the driving role of systemic inflammation. Autoimmun Rev 13(9):936–944CrossRefPubMed
60.
Lindhardsen J, Ahlehoff O, Gislason GH, Madsen OR, Olesen JB, Svendsen JH et al (2012) Risk of atrial fibrillation and stroke in rheumatoid arthritis: Danish nationwide cohort study. BMJ 344:e1257CrossRefPubMedPubMedCentral
61.
Solus J, Chung CP, Oeser A, Avalos I, Gebretsadik T, Shintani A et al (2008) Amino-terminal fragment of the prohormone brain-type natriuretic peptide in rheumatoid arthritis. Arthritis Rheum 58:2662–2669CrossRefPubMedPubMedCentral
62.
Yxfeldt A, Wallberg-Jonsson S, Hultdin J, Rantapää-Dahlqvist S (2003) Homocysteine in patients with rheumatoid arthritis in relation to inflammation and B-vitamin treatment. Scand J Rheumatol 32:205–210CrossRefPubMed
63.
Bozkurt B, Mann DL, Deswal A (2009) Biomarkers of inflammation in heart failure. Heart Fail Rev 15(4):331–341CrossRef
64.
Rauchhaus M, Doehner W, Francis DP, Davos C, Kemp M, Liebenthal C et al (2000) Plasma cytokine parameters and mortality in patients with chronic heart failure. Circulation 102(25):3060–3067CrossRefPubMed
65.
Deswal A, Petersen NJ, Feldman AM, Young JB, White BG, Mann DL (2001) Cytokines and cytokine receptors in advanced heart failure: an analysis of the cytokine database from the Vesnarinone trial (VEST). Circulation 103(16):2055–2059CrossRefPubMed
66.
Bozkurt B, Torre-Amione G, Smith Warren M, Soran OZ, Feldman AM, Mann DL (2001) Results of targeted anti-tumor necrosis factor therapy with etanercept (ENBREL) in patients with advanced heart failure. Am J Assoc 103:1044–1047
67.
Chung ES, Packer M, Lo KH, Fasanmade AA, Willerson JT, Anti-TNF Therapy Against Congestive Heart Failure Investigators (2003) Randomized, double-blind, placebo-controlled, pilot trial of infliximab, a chimeric monoclonal antibody to tumor necrosis factor-alpha, in patients with moderate-to-severe heart failure: results of the anti-TNF therapy against congestive heart failure (ATTACH) trial. Circulation 107:3133–3140CrossRefPubMed
68.
Coletta AP, Clark AL, Banarjee P, Cleland JG (2002) Clinical trials update: RENEWAL (RENAISSANCE and RECOVER) and ATTACH. Eur J Heart Fail 4:243–247CrossRef
69.
Gabriel SE (2008) Tumor necrosis factor inhibition: a part of the Solution or a part of the problem of heart failure in rheumatoid arthritis. Arthritis Rheum 58:637–640CrossRefPubMed
70.
Khanna D, McMahon M, Furst DE (2004) Anti tumor necrosis factor-α therapy and heart failure. Arthritis Rheum 50:1040–1048CrossRefPubMed
71.
Kotyla PJ, Owczarek A, Rakoczy J, Lewicki M, Kucharz EJ, Emery P (2012) Infliximab treatment increases left ventricular ejection fraction in patients with rheumatoid arthritis: assessment of heart function by echocardiography, endothelin-1, interleukin 6 and NT-probrain natriuretic peptide. J Rheumatol 39:4701–4706CrossRef
72.
Tomáš L, Lazúrová I, Pundová L, Oetterová M, Zakuciová M, Petrášová D, Studenčan M (2013) Acute and long-term effect of infliximab on humoral and echocardiographic parameters in patients with chronic inflammatory diseases. Clin Rheumatol 32(1):61–66CrossRefPubMed
73.
Curtis JR, Kramer JM, Martin C, Saag KG, Patkar N, Shatin D et al (2007) Heart failure among younger rheumatoid arthritis and Crohn’s patients exposed to TNF-α antagonists. Rheumatol 46:1688–1693CrossRef
74.
Al-Aly Z, Pan H, Zeringue A, Xian H, McDonald JR, El-Achkar TM, Eisen S (2011) Tumor necrosis factor-α blockade, cardiovascular outcomes, and survival in rheumatoid arthritis. Transl Res 157:10–16CrossRefPubMed
75.
Santos RC, Figueiredo VN, Martinz LC, Haro Moraes C, Quinaglia T, Boer-Martins L et al (2012) Infliximab reduces cardiac output in rheumatoid arthritis patients without heart failure. Rev Assoc Med Bras 58:698–702CrossRefPubMed
76.
Peters MJ, Welsh P, McInnes IB, Wolbink G, Dijkmans BA, Sattar N, Nurmohamed MT (2010) Tumour necrosis factor alpha blockade reduces circulating N-terminal pro-brain natriuretic peptide levels in patients with active rheumatoid arthritis: results from a prospective cohort study. Ann Rheum Dis 69(7):1281–1285CrossRefPubMed
77.
Setoguchi S, Schneeweiss S, Avorn J, Katz JN, Weinblatt M, Levin R et al (2008) Tumor necrosis factor-α antagonist use and heart failure in elderly patients with rheumatoid arthritis. Am Heart J 156:336–341CrossRefPubMedPubMedCentral
78.
Solomon DH, Rassen JA, Kuriva B, Chen L, Harrold LR, Graham DJ et al (2013) Heart failure risk among patients with rheumatoid arthritis starting a TNF antagonist. Ann Rheum Dis 72:1813–1818CrossRefPubMed
79.
Singh JA, Wells GA, Christensen R, Tanjong Ghogomu E, Maxwell L, Macdonald JK et al (2011) Adverse effects of biologics: a network meta-analysis and Cochrane overview. Cochrane Database Syst Rev 16(2):CD008794
80.
Suzuki A, Tamamura T, Okai T (2014) Five-year administration of tocilizumab to a patient with rheumatoid arthritis complicated by severe chronic heart failure. Jpn J Clin Immunol 37(6):488–492CrossRef
81.
Kobayashi Y, Kobayashi H, Giles JT, Hirano M, Nakajima Y, Takei M (2015) Association of tocilizumab with changes in measures of regional left ventricular function in rheumatoid arthritis, as assessed by cardiac magnetic resonance imaging. Int J Rheum Dis. doi: 10.​1111/​1756-185X.​12632
82.
Ikonomidis I, Lekakis JP, Nikolaou M, Paraskevaidis I, Andreadou I, Kaplanoglou T et al (2008) Inhibition of interleukin-1 by anakinra improves vascular and left ventricular function in patients with rheumatoid arthritis. Circulation 117:2662–2669CrossRefPubMed
83.
Ikonomidis I, Tzortzis S, Lekakis J, Paraskevaidis I, Andreadou I, Nikolaou M et al (2009) Lowering interleukin-1 activity with anakinra improves myocardial deformation in rheumatoid arthritis. Heart 95:1502–1507CrossRefPubMed
84.
Ikonomidis I, Tzortzis S, Andreadou I, Paraskevaidis I, Katseli C, Katsimbri P et al (2014) Increased benefit of Interleukin -1 inhibition on vascular function, myocardial deformation and twisting in patients with coronary artery disease and coexisting rheumatoid arthritis. Circ Cardiovasc Imaging 7:619–628CrossRefPubMed
85.
Fleischamnn RM, Schechtman J, Bennett R, Handel ML, Burmester GR, Tesser J et al (2003) Anakinra, a recombinant human interleukin-1 receptor antagonist, (r-metHuIL-1ra) in patients with rheumatoid arthritis. Arthritis Rheumatism 48:927–934CrossRef
86.
Abbate A, Van Tassel BW, Biondi-Zoccai G, Kontos MC, Grizzard JD, Spilmann DW et al (2013) Effects of Interleukin-1 blockade with anakinra on adverse cardiac remodeling and heart failure after acute myocardial infarction (from the Virginia commonwealth University-Anakinra remodeling Trial (2)(VCU-ART2) pilot study). J Cardiol 111:1394–1400CrossRef
Metadata
Title
Cardiac Impairment in Rheumatoid Arthritis and Influence of Anti-TNFα Treatment
Authors
Ivica Lazúrová
Ľubomír Tomáš
Publication date
01-06-2017
Publisher
Springer US
Published in
Clinical Reviews in Allergy & Immunology / Issue 3/2017
Print ISSN: 1080-0549
Electronic ISSN: 1559-0267
DOI
https://doi.org/10.1007/s12016-016-8566-3

Other articles of this Issue 3/2017

Clinical Reviews in Allergy & Immunology 3/2017 Go to the issue

ReviewPaper

Neutralization Versus Reinforcement of Proinflammatory Cytokines to Arrest Autoimmunity in Type 1 Diabetes

ReviewPaper

The Use of Cyclosporine A in Rheumatology: a 2016 Comprehensive Review

ReviewPaper

Role of Mast Cells in the Pathogenesis of Multiple Sclerosis and Experimental Autoimmune Encephalomyelitis

OriginalPaper

The Management of Autoimmune Hepatitis Patients with Decompensated Cirrhosis: Real-World Experience and a Comprehensive Review

ReviewPaper

Mold and Human Health: a Reality Check

ReviewPaper

Significance of Interleukin-6/STAT Pathway for the Gene Expression of REG Iα, a New Autoantigen in Sjögren’s Syndrome Patients, in Salivary Duct Epithelial Cells
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits