Analysis of the impact of pharmacological treatment on arterial stiffness in patients with connective tissue diseases

Arterial stiffness is a critical but underrecognized factor in cardiovascular morbidity among patients with connective tissue diseases, including rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and idiopathic inflammatory myopathies. This review synthesizes evidence on pharmacological interventions, emphasizing benefits and limitations. IL-6 inhibitors and TNF-α blockers improve vascular outcomes by reducing inflammation and enhancing endothelial function. Methotrexate offers modest effects, whereas glucocorticoids, though effective for acute control, contribute to long-term vascular damage. Emerging therapies show promise in modulating arterial compliance through novel mechanisms. The review underscores the value of integrating vascular biomarkers, such as pulse wave velocity and cardio-ankle vascular index, into clinical practice. By contextualizing vascular responses to immunomodulatory treatments, this work advocates for a more nuanced, personalized strategy to mitigate cardiovascular risk in connective tissue disease patients through combined pharmacological and non-pharmacological approaches.