Evidence-based Recommendations for the Management of Comorbidities in Rheumatoid Arthritis, Psoriasis, and Psoriatic Arthritis: Expert Opinion of the Canadian Dermatology-Rheumatology Comorbidity Initiative

Abstract

These practical evidence-based recommendations can guide management of comorbidities in patients with RA, PsA, and PsO and optimize outcomes.

Prevalence of cardiovascular-related comorbidity in ankylosing spondylitis, psoriatic arthritis and psoriasis in primary care: a matched retrospective cohort study

“…Given the increased rates of cardiovascular disease in patients with inflammatory disorders, it is increasingly important to monitor cardiovascular comorbidities [17]. Within this UK primary care consultation database, the rates of hypertension were significantly greater in those with AS and PsA compared to matched cohorts, although the prevalence of ischaemic heart disease, diabetes mellitus or hyperlipidaemia was similar between the AS and PsA cohorts compared to their matched cohorts.…”

Consensus Statement on the Management of Comorbidity in Patients with Rheumatoid Arthritis and Psoriasis

“…Significantly, the Canadian document also reflects the effect of the recommendations on clinical practice. We observe that, while the presence of depression is rarely considered by rheumatologists and dermatologists, these 3 final recommendations have a greater effect (≥ 50%) on daily clinical practice 1 .…”

“…As in the Spanish recommendations (Table 1), most of the 19 recommendations from the Canadian Initiative received a grade C/D from the Oxford Centre for Evidence-based Medicine, with a level of agreement > 80% in all of them 1,2 . The overall assessment of the recommendations, according to the Centre for Evidence-based Medicine, is low (C/D, with A the highest and D the lowest) because they are based on expert opinion, although their influence is strong, which can be inferred by their wide applicability to clinical practice.…”

“…We have read with great interest the recommendations for the management of comorbidities in rheumatoid arthritis (RA), psoriasis (PsO), and psoriatic arthritis (PsA) made by the Canadian Dermatology-Rheumatology Comorbidity Initiative 1 . The work is very interesting and comprehensive, and we congratulate the authors for combining more general recommendations for the management of the comorbidity of these 3 diseases.…”

Clinical and epidemiological characterization of psoriasis and psoriatic arthritis in a multidisciplinary assessment model

“…The specific scales of each specialist and the results in the following visits will show if this multidisciplinary model can really change the course, quality of life and management in patients with psoriasis. This management has been recommended previously by the Canadian Dermatology-Rheumatology Comorbidity Initiative [11]. This is the first overview of our clinic to better understand the problem of psoriasis, however the model is designed for the management not only of psoriasis and psoriatic arthritis, but also associated comorbidities looking for a real impact on the management and quality of life of our patients with psoriasis, thus we strongly believe that our multidisciplinary model evaluated over time, will make a difference in the management of this complex disease.…”