The growing role of cardio-rheumatology clinics
The evolving landscape of cardiovascular care has witnessed the rise of specialized clinics that integrate a care team approach involving cardiology with disciplines such as rheumatology, immunology and dermatology. Although only a few hospitals currently have cardio-rheumatology clinics, the number is rapidly growing. The pace of new clinics coming online may also accelerate as more cardiology programs seek expertise in the body's inflammatory response, which is major contributor to heart attacks. Until last year there were no drugs indicated to treat coronary inflammation, but that has changed and interest in coronary inflammation has exploded.
At the forefront of this movement is Brittany Nicole Weber, MD, PhD, the director of the Cardio-Rheumatology Clinic at Brigham and Women's Hospital. She leads a team that collaborates across specialties to address complex, inflammation-related cardiovascular risks in patients with chronic conditions such as lupus, psoriasis and rheumatoid arthritis.
"It's an exciting time for us in cardio-rheumatology because we're finally seeing the integration of cardiology and immunology, especially with the increasing understanding of the role of inflammation in cardiovascular disease," she said in an interview with Cardiovascular Business.
New clinical are bridging the gap between cardiology, rheumatology and immunology
Weber's clinic is part of a growing network of cardio-rheumatology programs across the country. These clinics focus on patients who have both cardiovascular risks and systemic inflammatory diseases. Studies have shown these patients also face a higher risk of coronary disease and have a higher rate of myocardial infarctions, which is directly related to their bodies' overactive inflammatory response.
"It's not just about cardiology," she emphasized. "We work closely with rheumatologists, dermatologists, and even primary care physicians to provide comprehensive care. This multidisciplinary approach is critical, especially as we develop new care models that can address the complex needs of our patients."
For example, a patient with rheumatoid arthritis may face heightened cardiovascular risks due to the nature of their inflammatory disease and the medications they take. Janus kinase (JAK) inhibitors are often used to treat chronic inflammatory disorders by blocking the activity of Janus kinase enzymes.
"We're dealing with a very nuanced area of medicine," Weber said. "Our patients often come to us with complex needs, such as those requiring JAK inhibitors for rheumatoid arthritis. These medications, while effective for their primary purpose, can carry additional cardiovascular risks. It's our job to mitigate those risks, whether through statins, lifestyle changes, or newer therapies like biologics."
Looking to the future, Weber envisions a healthcare landscape where opportunistic screening for cardiovascular risks in patients with inflammatory diseases may become routine. "The goal is to integrate this into broader health systems, using tools like AI to identify at-risk patients and guide them towards appropriate interventions," she said.
FDA clears colchicine for preventive treatment of coronary inflammation
The importance of these clinics is underscored by recent advancements in cardiovascular medicine, particularly the FDA's approval of colchicine in 2023 for the treatment of coronary inflammation. This approval marked the first time a drug was specifically indicated for coronary inflammation, a key factor in the development of heart disease. Prior to this, treatments like statins primarily targeted cholesterol, addressing only one cause of coronary disease.
Weber noted that this new drug indication has led to a surge in interest in cardio-rheumatology clinics.
"We're now seeing more referrals and consultations as healthcare providers become more aware of the connection between systemic inflammation and heart disease," she said.
Watch a video with Paul M. Ridker, MD, director of the center for cardiovascular disease prevention at Brigham and Women's, on the data supporting drug therapy for coronary inflammation.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com