Early Control of Rheumatoid Arthritis Improves Hemostatic Imbalance

Effective antirheumatic treatments, especially tocilizumab and other biological drugs, have been shown to improve hemostatic imbalances in patients with newly diagnosed rheumatoid arthritis (RA) during the first 24 weeks after diagnosis. This improvement may help mitigate the elevated risks of thrombosis in this population. The study, led by Bas Dijkshoorn, MD, MSc, PhD candidate, involved 24 participants who were treated with methotrexate and randomized additional treatments including certolizumab pegol, abatacept, or tocilizumab. Biomarkers for hemostasis were analyzed, showing significant reductions in factors such as fibrinogen, D-dimer, and overall hemostatic potential (OHP) after 24 weeks of treatment. Tocilizumab treatment was particularly effective, showing a 73% reduction in OHP compared to other treatments. The study underscores the importance of early treatment in RA to reduce the pro-coagulant state and highlights the effectiveness of biological treatments, especially IL-6 receptor inhibition. Additionally, recent research from the American College of Rheumatology (ACR) Convergence 2024 found that glucocorticosteroids (GCs) increase cardiovascular disease (CVD) and infection mortality risk, even after cessation, emphasizing the need for careful consideration and ongoing discussions about steroid use in RA treatment.