Cardioprotective mechanisms and efficacy of colchicine, methotrexate, hydroxychloroquine, sulfasalazine and leflunomide in inflammatory rheumatic and musculoskeletal diseases

Clicks: 9
ID: 333834
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Emerging

Ranked #333 of 339 articles by views in Lara D. Veeken

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 339 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Chronic systemic inflammation contributes to the excess risk of atherosclerotic cardiovascular disease (ASCVD) in inflammatory rheumatic and musculoskeletal diseases (RMDs), raising the possibility that anti-inflammatory treatment may modify vascular risk. This review sought to critically review the mechanistic and clinical evidence for atheroprotection with colchicine and the commonly used conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) methotrexate, hydroxychloroquine, sulfasalazine and leflunomide. We performed a targeted narrative review of key experimental studies, randomized cardiovascular outcome trials, observational RMD cohorts and systematic reviews, prioritizing evidence directly relevant to ASCVD outcomes and cardiometabolic mechanisms. Colchicine has the strongest randomized evidence for reducing recurrent ASCVD events in patients with established coronary disease, with supportive observational data in gout. Methotrexate is associated with fewer cardiovascular events in rheumatoid arthritis (RA), whereas the CIRT trial was neutral in patients without inflammatory arthritis. Hydroxychloroquine has favorable lipid, glycaemic and antithrombotic effects and observational associations with lower cardiovascular risk in RA and systemic lupus erythematosus (SLE), but no definitive cardiovascular outcome trial. Evidence for sulfasalazine is limited and observational, and human data for leflunomide are conflicting. Cardiovascular benefit differs substantially between agents and is most convincing for colchicine in secondary prevention and for inflammation control with methotrexate in RA. Dedicated prospective trials in inflammatory RMD populations are needed before any csDMARD can be prescribed primarily for ASCVD prevention.
Reference Key
openalex_W7223466335 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Rabia Agca, Sreen S Mohamed, Călin D. Popa, Caroline Mpg van Durme, Harald E. Vonkeman, Suat Şimşek, Sjoerd C. Heslinga, Sander I. van Leuven, Michael Twahier Nurmohamed
Are you one of these authors? Claim your profile
Journal Lara D. Veeken
Year 2026
DOI
10.1093/rheumatology/keag596
URL
https://doi.org/10.1093/rheumatology/keag596
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.