Assessment of Cardiovascular Risk in Patients with Rheumatoid Arthritis

Matteson, Eric L.; Mankad, Rekha

doi:10.3899/jrheum.161025

Cited by 4 publications

(3 citation statements)

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“…A pooled analysis demonstrated the CV risk was 48% higher in patients with RA than those in general individuals [6]. The mechanism underlying the excess risk of CV events in RA remains unclear, but the traditional risk factors, systematic inflammation and the other RA-specific (mainly the disease activity) may play a role in this increased risk [7]. Particularly, recognition of CV risk of anti-rheumatism treatment was important to guide the clinical management of RA.…”

Section: Introductionmentioning

confidence: 99%

Baricitinib induces LDL-C and HDL-C increases in rheumatoid arthritis: a meta-analysis of randomized controlled trials

et al. 2019

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Background Baricitinib, an oral-administrated selective inhibitor of the JAK1 and JAK2, is recently approved for rheumatoid arthritis (RA) treatment. With the aim to provide some insights on the clinical safety, the current study mainly focused on the effect of baricitinib on low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels and cardiovascular risk. Methods The net change scores [least squares mean (LSM) and mean change] of LDL-C and HDL-C levels from baseline with the comparison of baricitinib versus placebo were pooled, respectively. Risk rations (RR) of major cardiovascular events (MACEs) and differences of cardiovascular risk scores at the end of treatment across groups were compared. Results Six trials with randomized 3552 patients were finally included in summary analysis. Results showed that baricitinib significantly increased LDL-C levels, the net mean change was 13.15 mg/dl with 95% CI 8.89~17.42 (I 2 = 0) and the net LSM was 11.94 mg/dl with 95% CI 7.52~16.37 (I 2 = 84%). HDL-C also increased obviously with the net LSM change was 7.19 mg/dl (95% CI, 6.05~8.33, I 2 = 47%) and net mean change was 5.40 mg/dl (95% CI, 3.07~7.74, I 2 = 10%). Subgroup and meta-regression analysis demonstrated baricitinib induced LDL-C and HDL-C increases in a dose-response manner. However, both the pooled RRs of MACEs and differences of cardiovascular risk scores were not statistically significant across groups. Conclusion This study confirmed that baricitinib induced a stable dose-response increase in LDL-C and HDL-C levels. Since the causality association between altered lipids and cardiovascular risk was not identified yet, this issue cannot be completely dismissed. Future research is needed to fully dissect the implications of these lipid changes. Electronic supplementary material The online version of this article (10.1186/s12944-019-0994-7) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Baricitinib induces LDL-C and HDL-C increases in rheumatoid arthritis: a meta-analysis of randomized controlled trials

et al. 2019

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“…Повышенный риск ССЗ при ВА обусловлен ускоренным развитием атеросклероза, ассоциированным с хроническим системным воспалительным процессом. Тем не менее традиционные факторы риска ССЗ (артериальная гипертензия (АГ), курение, дислипидемия) также имеют значение для больных РА [4]. По результатам опубликованного в 2012 г. метаанализа проведенных исследований в сравнении с общей популяцией риск развития ССЗ у больных РА выше на 48 %, инфаркта миокардана 68 %, инсульта и транзиторной ишемической атаки -на 41 % и хронической сердечной недостаточности -на 87 % [5].…”

Section: сердечно-сосудистые заболевания у больных воспалительными ар...unclassified

Cardiovascular risk in patients with inflammatory arthritis

Anichkov,

Shostak,

Timofeev

2024

Klinicist

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Rheumatoid and other inflammatory arthritis (ankylosing spondylitis and psoriatic arthritis) have a high risk of cardiovascular disease (CVD). It is caused by the accelerated development of atherosclerosis associated with a chronic systemic inflammatory process. Nevertheless, traditional CVD risk factors (hypertension, smoking, dyslipidemia) are also important for patients with inflammatory arthritis. The greatest amount of data has been accumulated regarding the relationship between CVD and rheumatoid arthritis. Due to the difficulties in diagnosing coronary heart disease and other CVD, it is of great importance to identify patients at high and very high risk. The use of scales for assessing the total cardiovascular risk SCORE/SCORE 2 with a coefficient of 1.5 allows to identify patients who need measures to reduce their high risk of CVD. Control of the of the disease activity, lifestyle modification, therapy with statins and antihypertensive drugs in accordance with current guidelines, caution when prescribing non-steroidal anti-inflammatory drugs and minimizing the dose of glucocorticoids are the main components of the strategy for reducing the risk of CVD in patients with inflammatory arthritis.

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“…Rheumatoid arthritis is a debilitating chronic disorder with high morbidity. 1,2 With recent advances in rheumatology, more emphasis is placed on early diagnosis since early intervention leads to better outcomes. 1,3,4 Therefore, the international classification criteria for rheumatoid arthritis has amended the required duration of symptoms for diagnosis from 6 months in 1987 5 , to 6 weeks in 2010.…”

Section: Introductionmentioning

confidence: 99%

Delay in presentation of patients with rheumatoid arthritis for specialty care

Dandeniya¹,

Rubasinghe

2021

J of Cey Coll of Phy

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Introduction:Early diagnosis and intervention is known to improve the outcomes in patients with rheumatoid arthritis. Information on the time duration from the symptom onset of rheumatoid arthritis to the presentation to specialty care in Sri Lanka is not available. The aim of this study was to evaluate the time duration from symptom onset to the first visit of patients to a rheumatology specialty clinic in Sri Lanka and changing trends over a period.Methods: This retrospective observational study was carried out in the rheumatology and rehabilitation clinic at the National Hospital of Sri Lanka. Data were collected through an interviewer-administered questionnaire from 60 consecutive consenting patients with rheumatoid arthritis attending the clinic over a period of one month. Further information was added or clarified by perusing clinic records. Data was analyzed using SPSS software version 17.0 and Microsoft Excel 2010.Results: Sixty patients were recruited to the study. Their mean age was 54.23 years (range 19-76 years) and 58 were women. Among them, 38 patients were positive for either rheumatoid factor or anti-cyclic citrullinated peptide and were considered as seropositive. The average time duration from symptom onset to the first visit to the rheumatology clinic was 15.86 months (SD=18.38). The analysis of trends over 13 years showed an improving trend with gradually shortening time duration. There was no statistically significant difference in the time lag of the first visit to the rheumatology clinic between seronegative and sero-positive groups (p=0.976. CI 95%). Conclusion:There was a significant delay in presentation of patients with rheumatoid arthritis to specialty care, with a trend of gradual improvement over recent years. For optimum treatment outcome, referral of suspected cases to specialty care within 6 weeks of presentation to the first medical contact is recommended. We found that there is a significant delay in referral system that needs remedying to meet the standard recommendations.

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Assessment of Cardiovascular Risk in Patients with Rheumatoid Arthritis

Cited by 4 publications

References 20 publications

Baricitinib induces LDL-C and HDL-C increases in rheumatoid arthritis: a meta-analysis of randomized controlled trials

Baricitinib induces LDL-C and HDL-C increases in rheumatoid arthritis: a meta-analysis of randomized controlled trials

Cardiovascular risk in patients with inflammatory arthritis

Delay in presentation of patients with rheumatoid arthritis for specialty care

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