Increased Cardiovascular Risk in Psoriatic Arthritis: Results From a Case-Control Monocentric Study

Degboé, Yannick; Koch, Richard; Zabraniecki, Laurent; Jamard, B.; Couture, Guillaume; Ruidavets, Jean Bernard; Ferrières, Jean; Ruyssen‐Witrand, Adeline; Constantin, Arnaud

doi:10.3389/fmed.2022.785719

Cited by 8 publications

(7 citation statements)

References 37 publications

(42 reference statements)

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“…Reassuringly, although AIIRD patients are known to be at increased risk of infections [ 41 , 42 , 43 ] and specifically of HZ reactivation [ 5 , 44 ], we did not find an increase in the risk of HZ reactivation following mRNA vaccination in SpA patients relative to the general population. This finding is particularly noteworthy given that the AIIRD patient population has been aggressively immunized against COVID-19 due to the concern of potentially more severe outcomes of this infection in immunosuppressed individuals and particularly in those with CVD-related comorbidities, as found in PsA patients [ 32 , 45 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

The Risk of Herpes Zoster Events in Patients with Spondyloarthritis and the Effect of BNT162b2 mRNA COVID-19 Vaccine

Gazitt,

Hayat,

Stein

et al. 2024

Vaccines

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The data on the risk of herpes zoster (HZ) in spondyloarthropathy (SpA) patients are sparse, especially regarding its association with the novel mRNA COVID-19 vaccines and immunosuppressants. We aimed to evaluate whether SpA diagnosis and/or immunosuppressant use affect HZ risk and the influence of mRNA COVID-19 vaccination. We assessed the association between SpA (psoriatic arthritis (PsA) and ankylosing spondylitis (AS)) diagnoses and HZ in a large population database with patients matched by age and sex to controls. We also assessed the association between the COVID-19 vaccine and new-onset HZ using two nested case–control studies, identifying all new HZ cases diagnosed from 1 January–31 December 2021 within the SpA and general population cohorts, matched randomly by sex, age and HZ index date to controls without HZ. Exposure to mRNA COVID-19 vaccination was ascertained in the 6 weeks prior to the index date both in cases and controls. In our results, the incidence rate of HZ was higher in PsA patients vs. the general population, at 1.03 vs. 0.64 per 100 person-years, respectively (adjusted HR = 1.55; 95%CI, 1.19–2.02). Within the SpA group, Jak-I treatment was associated with a higher risk of developing new-onset HZ (adjusted OR = 3.79; 1.15–12.5). Multivariable conditional logistic regression models we used showed no association between COVID-19 vaccination and new-onset HZ among the SpA patients (OR = 1.46; 0.68–3.14).

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Section: Discussionmentioning

confidence: 99%

The Risk of Herpes Zoster Events in Patients with Spondyloarthritis and the Effect of BNT162b2 mRNA COVID-19 Vaccine

Gazitt,

Hayat,

Stein

et al. 2024

Vaccines

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“…Current evidence suggests that effectively managing comorbid conditions enhances overall well-being and reduces hospital readmissions. For instance, addressing cardiovascular risk factors, such as hypertension and hyperlipidemia, is crucial given the increased cardiovascular morbidity and mortality observed in patients with PsA [ 22 , 23 ]. Comprehensive care plans should include regular monitoring, lifestyle modifications, and pharmacological interventions to mitigate these risks.…”

Section: Discussionmentioning

confidence: 99%

Thirty-Day Readmissions After Hospitalization for Psoriatic Arthritis

Uwumiro,

Anighoro,

Ajiboye

et al. 2024

Cureus

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Background Psoriatic arthritis (PsA) is correlated with higher rates of major adverse cardiovascular events and autoimmune disorders than the general population, leading to more frequent hospitalizations. This study assessed the rates and characteristics of index and 30-day readmissions among adults hospitalized for PsA and evaluated the indications and predictors of 30-day readmissions across the United States. Methodology We analyzed the 2020 Nationwide Readmissions Database for adult PsA hospitalizations using the International Classification of Diseases, Tenth Revision, Clinical Modification codes. To compare baseline characteristics between index admissions and readmissions, we used chi-square tests. We used ranking commands to identify the most common indications for readmissions and multivariable Cox regression analysis to identify the predictors of readmissions. The primary endpoints were the rates and characteristics of index and 30-day readmissions. The secondary endpoint was the predictors of readmission within 30 days of index hospital discharge. Results Approximately 842 index hospitalizations for PsA were analyzed. Of these, 244 (29%) resulted in 30-day readmissions, with the primary causes being acute kidney failure, major depression, and heart failure. Readmitted patients had a mean age of 48.2 years (SD = 6.4 years) compared with 54.6 years (SD = 2.2 years) in index hospitalizations (p = 0.147). More readmitted patients were uninsured than index hospitalizations (18.6% vs. 4.4%; p = 0.015). The mean length of stay for readmissions was 7.2 days compared with 3.9 days for index admissions. The mean total hospital costs were US$31,424 for index admissions and US$60,147 for readmissions (p < 0.001). Significant differences in comorbidities such as hypertension (24.8% vs. 40.1%, p = 0.032), liver disease (29% vs. 7.9%, p = 0.020), uveitis (9.4% vs. 4.5%, p < 0.001), inflammatory bowel disease (8.6% vs. 3.8%, p < 0.001), and alcohol use disorder (29% vs. 7.8%, p = 0.002) were observed between readmissions and index admissions. Age <40 years (adjusted hazard ratio (AHR) = 2.35; p = 0.047), home healthcare (AHR = 5.87; p = 0.035), residence in the same state as the hospital (AHR = 1.24; p = 0.018), and secondary diagnoses of inflammatory bowel disease (AHR = 2.33; p < 0.001) or deep venous thrombosis (AHR = 3.80; p = 0.007) were correlated with an increased likelihood of readmission. Conclusions About one in three hospitalizations for PsA result in readmission within 30 days of initial discharge. Age <40 years, discharge to home healthcare, and a secondary diagnosis of inflammatory bowel disease or deep venous thrombosis were correlated with an increased likelihood of readmission.

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“…An elevated risk of CV and cerebrovascular events compared to the general population has also been reported for psoriatic arthritis (PsA) [2,7]. The increased CV risk associated with RA and other chronic inflammatory conditions is likely caused by the complex interplay of traditional CV risk factors, chronic systemic inflammation, and side effects related to the use of certain antirheumatic medications [8,9]. Although a similar figure has been proposed for PsA, to what extent these arthropathies differ is yet to be clarified.…”

Section: Introductionmentioning

confidence: 94%

“…Several studies have investigated the epidemiology of traditional CV risk factors and MetS in patients with RA and PsA [9,10,[12][13][14][15]. A study based on the data from a US health insurance claim database estimated the prevalence of CV risk factors during the 12 months before diagnosis and their incidence rates during follow-up in patients with RA, PsA or psoriasis [12].…”

Section: Introductionmentioning

confidence: 99%

Metabolic Syndrome and Its Components Have a Different Presentation and Impact as Cardiovascular Risk Factors in Psoriatic and Rheumatoid Arthritis

Atzeni,

La Corte,

Cirillo

et al. 2023

JCM

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Patients with chronic inflammatory arthritis have a higher cardiovascular (CV) risk than the general population. Traditional CV risk factors are clearly implicated, while the impact of metabolic syndrome (MetS) is less defined. The aim of this study was to compare MetS prevalence and impact on the CV risk in psoriatic arthritis (PsA) versus rheumatoid arthritis (RA). A retrospective analysis of real-world data of PsA and RA patients referred to a rheumatology clinic was conducted. The following data were extracted and compared: demographic data; clinical data; presence of traditional CV risk factors and MetS. Univariate and multivariate models were used to compare the impact of MetS and its components in patients with PsA versus RA. Overall, 170 patients were included (PsA: 78; RA; 92). The two groups differed significantly in mean age, disease duration, and presence of MetS, while other variables were comparable. Univariate and multivariate analysis identified distinct predictors of MetS in PsA (hypertension) and RA (dyslipidemia). The history of CV events was similar in the two groups. Predictors of CV events were MetS and most of its components in PsA, while dyslipidemia was the strongest predictor in RA. These associations were stronger in PsA than in RA. In conclusion, the impact of MetS and its components is different in PsA and RA. The association of these risk factors with CV events is stronger in PsA than in RA. This suggests the implication of different mechanisms, which may require distinct strategies for the prevention of CV events in PsA and RA.

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Increased Cardiovascular Risk in Psoriatic Arthritis: Results From a Case-Control Monocentric Study

Cited by 8 publications

References 37 publications

The Risk of Herpes Zoster Events in Patients with Spondyloarthritis and the Effect of BNT162b2 mRNA COVID-19 Vaccine

The Risk of Herpes Zoster Events in Patients with Spondyloarthritis and the Effect of BNT162b2 mRNA COVID-19 Vaccine

Thirty-Day Readmissions After Hospitalization for Psoriatic Arthritis

Metabolic Syndrome and Its Components Have a Different Presentation and Impact as Cardiovascular Risk Factors in Psoriatic and Rheumatoid Arthritis

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