Psoriasis, psoriatic arthritis increases cardiovascular risk
the Clinical Advisor take:
The risk of major adverse cardiovascular events (MACE) increases in patients with rheumatoid arthritis (RA) and in those with psoriatic arthritis (PsA) or psoriasis who aren’t taking medication, according to a study published in the Annals of the Rheumatic Diseases.
Lead researcher Alexis Ogdie, MD, of the Perelman School of Medicine at the University of Pennsylvania, and colleagues found that cardiovascular events were more common in patients with psoriasis or PsA only if they were not on medication, but the risk was higher in RA patients regardless of whether or not they took medication.
In a population-based longitudinal cohort study, the researchers looked at patients aged 18 to 89 years with PsA, RA, or psoriasis from The Health Improvement Network (THIN), a primary care medical record database in the United Kingdom. Each participant was matched with up to 10 controls based on practice and index date.
Outcomes included cardiovascular death, myocardial infarction, cerebrovascular accidents, and the composite outcome (MACE). The researchers also hypothesized an interaction between disease status and disease-modifying antirheumatic drug (DMARD) use.
The researchers found that the risk of MACE was higher in patients with PsA who were not prescribed a DMARD, patients with RA (regardless of DMARD use), patients with psoriasis who were not prescribed a DMARD, and patients with severe psoriasis.
The results of this study indicate that all patients affected by psoriasis, PsA, or RA should have their cardiovascular risk addressed by clinicians.
Psoriasis and psoriatic arthritis increase cardiovascular risks.
Objectives We aimed to quantify the risk of major adverse cardiovascular events (MACE) among patients with psoriatic arthritis (PsA), rheumatoid arthritis (RA) and psoriasis without known PsA compared with the general population after adjusting for traditional cardiovascular risk factors.
Results Patients with PsA (N=8706), RA (N=41 752), psoriasis (N=138 424) and unexposed controls (N=81 573) were identified. After adjustment for traditional risk factors, the risk of MACE was higher in patients with PsA not prescribed a DMARD (HR 1.24, 95% CI 1.03 to 1.49), patients with RA (No DMARD: HR 1.39, 95% CI 1.28 to 1.50, DMARD: HR 1.58, 95% CI 1.46 to 1.70), patients with psoriasis not prescribed a DMARD (HR 1.08, 95% CI 1.02 to 1.15) and patients with severe psoriasis (DMARD users: HR 1.42, 95% CI 1.17 to 1.73).
Conclusions Cardiovascular risk should be addressed with all patients affected by psoriasis, PsA or RA.