Focus on the potential effects of treatments for spondylarthritides on cardiovascular risk

Ingegnoli, Francesca; Gualtierotti, Roberta; Artusi, Carolina; Lubrano, Ennio

doi:10.1586/1744666x.2014.875468

Cited by 6 publications

(6 citation statements)

References 73 publications

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“…Our patient showed a baseline unfavorable TC/HDL ratio, very close to the proposed cut-off of >5 for high risk of CV events, although TC and TG serum levels were still in the normal range [18,19]. It is common knowledge that PsA is associated with a high prevalence of metabolic syndrome, obesity, diabetes mellitus and abnormal serum lipid levels, specifically hypertriglyceridemia [17,18,19]. Metabolic syndrome and psoriasis share a chronic inflammatory state, characterized by production of proinflammatory cytokines such as tumor necrosis factor-alpha (TNF-α) and interleukin (IL)-6 [20].…”

Section: Discussionmentioning

confidence: 58%

“…PsA is associated with a higher prevalence of metabolic syndrome, obesity, diabetes mellitus and abnormal serum lipid levels, in particular hypertriglyceridemia, when compared to rheumatoid arthritis (RA) patients [15,16,17]. Our patient showed a baseline unfavorable TC/HDL ratio, very close to the proposed cut-off of >5 for high risk of CV events, although TC and TG serum levels were still in the normal range [18,19]. It is common knowledge that PsA is associated with a high prevalence of metabolic syndrome, obesity, diabetes mellitus and abnormal serum lipid levels, specifically hypertriglyceridemia [17,18,19].…”

Section: Discussionmentioning

confidence: 68%

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Efficacy and Metabolic Effect on Serum Lipids of Apremilast in Psoriatic Arthritis: A Case Report

Gualtierotti

Lucia

2019

JCM

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Psoriatic arthritis (PsA) is a chronic immune-mediated disease manifesting as joint inflammation with functional impairment associated with psoriasis. Recently, PsA has emerged as a systemic disease with several comorbidities, such as cardiovascular diseases and metabolic disorders. Apremilast is a targeted synthetic disease-modifying anti-rheumatic drug (tsDMARD) directed against phosphodiesterase 4 (PDE4) with demonstrated efficacy and safety in PsA and psoriasis. We report the case of a patient with PsA manifesting as arthritis, dactylitis, mild psoriasis and a significantly reduced health-related quality of life (HRQoL). Treatment with apremilast in association with methotrexate led to a quick improvement of joint and skin involvement with a stable amelioration of HRQoL. Furthermore, we observed a persistent favorable shift of serum lipid profile. Our observations suggest that apremilast is effective in controlling mild skin and joint involvement, including dactylitis, and suggest a potentially advantageous metabolic effect in patients with PsA.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 68%

Efficacy and Metabolic Effect on Serum Lipids of Apremilast in Psoriatic Arthritis: A Case Report

Gualtierotti

Lucia

2019

JCM

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“…Patients with IRD have a higher risk of CV events than the general population, and this burden is not fully explained by traditional risk factors, with chronic inflammation playing a pivotal role [ 4 , 6 , 86 ]. Recently, the European League against Rheumatism (EULAR) suggested recommendations for the assessment and management of CV risk in RA patients [ 87 ].…”

Section: Methodsmentioning

confidence: 99%

“…Due to the association with multiple comorbidities, IRD need a multidisciplinary management. Compared with healthy subjects, patients with IRD are also burdened with a higher risk of infections, due to the immunosuppressive treatment with disease-modifying anti-rheumatic drugs (DMARDs) and corticosteroids, an increased cardiovascular (CV) risk, and a major risk of an altered coagulation state, in turn due both to inflammation and, in some cases, to the presence of anti-phospholipid antibodies (aPL) [ 2 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Perioperative Management of Patients with Inflammatory Rheumatic Diseases Undergoing Major Orthopaedic Surgery: A Practical Overview

2018

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Patients with inflammatory rheumatic diseases often need orthopaedic surgery due to joint involvement. Total hip replacement and total knee replacement are frequent surgical procedures in these patients. Due to the complexity of the inflammatory rheumatic diseases, the perioperative management of these patients must envisage a multidisciplinary approach. The frequent association with extraarticular comorbidities must be considered when evaluating perioperative risk of the patient and should guide the clinician in the decision-making process. However, guidelines of different medical societies may vary and are sometimes contradictory. Orthopaedics should collaborate with rheumatologists, anaesthesiologists and, when needed, cardiologists and haematologists with the common aim of minimising perioperative risk in patients with inflammatory rheumatic diseases. The aim of this review is to provide the reader with simple practical recommendations regarding perioperative management of drugs such as disease-modifying anti-rheumatic drugs, corticosteroids, non-steroidal anti-inflammatory drugs and tools for a risk stratification for cardiovascular and thromboembolic risk based on current evidence for patients with inflammatory rheumatic diseases.

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“…Characteristic features of this at times powerful reaction are acute phase proteins, including C-reactive protein (CRP) produced by the liver following proinflammatory cytokine stimulation. Comorbidities are frequently linked to arthritis, and these may be a result of both intrinsic factors, such as genetic predisposition, age and sex, and extrinsic ones, such as environmental variables, including diet and therapeutic drugs [4]. The inflammatory process is of crucial importance in this context and may be both affected by and responsible for the effects of these factors.…”

Section: Common Inflammatory Features and Accelerated Atherosclerosis...mentioning

confidence: 99%

How the Mediterranean diet and some of its components modulate inflammatory pathways in arthritis

Oliviero¹,

Spinella²,

Fiocco³

et al. 2015

Swiss Med Wkly

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Arthritis encompasses a heterogeneous group of diseases characterised by inflammation that leads not only to joint damage, bone erosion, severe pain and disability, but also affects other organs of the body, resulting in increased morbidity and mortality. Although the mechanisms underlying the pathogenesis of joint diseases are for the most part unknown, a number of nutrient and non-nutrient components of food have been shown to affect the inflammatory process and, in particular, to influence clinical disease progression. The Mediterranean diet model has already been linked to a number of beneficial health effects: both fat and non-fat components of the Mediterranean dietary pattern have been shown to exert important anti-inflammatory activities by affecting the arachidonic acid cascade, the expression of some proinflammatory genes, and the activity of immune cells. N-3 polyunsaturated fatty acids, in particular, have been shown to affect lymphocyte and monocyte functions, crucially involved in adaptive and innate immunity. Although some aspects concerning the mechanisms of action through which the Mediterranean diet pattern exerts its beneficial effects remain to be elucidated, arthritis patients may potentially benefit from it in view of their increased cardiovascular risk and the treatment they require which may have side effects.

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Focus on the potential effects of treatments for spondylarthritides on cardiovascular risk

Cited by 6 publications

References 73 publications

Efficacy and Metabolic Effect on Serum Lipids of Apremilast in Psoriatic Arthritis: A Case Report

Efficacy and Metabolic Effect on Serum Lipids of Apremilast in Psoriatic Arthritis: A Case Report

Perioperative Management of Patients with Inflammatory Rheumatic Diseases Undergoing Major Orthopaedic Surgery: A Practical Overview

How the Mediterranean diet and some of its components modulate inflammatory pathways in arthritis

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