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Patients with chronic inflammatory diseases, such as rheumatoid arthritis (RA), systemic lupus erythematosus, psoriasis and Crohn's disease have an increased atherosclerotic risk which cannot be explained by traditional cardiovascular risk factors alone. Inflammatory pathways are implicated in this increased vascular risk. The involvement of cytokine-related signaling pathways in inflammatory diseases has prompted the development of many therapeutic strategies aimed at their modulation to limit disease severity and progression. Whether modulation of these pathways would similarly alter the inflammatory processes related to accelerated atherosclerosis remains unknown. In this review we will focus on the role of pro-inflammatory cytokines and their inhibitors in RA, and whether they may be causal in the accelerated atherosclerosis seen in these patients.