Cardiovascular risk comorbidities in rheumatoid arthritis patients and the use of anti-rheumatic drugs: a cross-sectional real-life study.

Autor: Vicente GNS; Universidade do Sul de Santa Catarina- UNISUL, Florianópolis, SC, Brazil. gustavo_schincariol@hotmail.com., Pereira IA; Universidade do Sul de Santa Catarina- UNISUL, Florianópolis, SC, Brazil., de Castro GRW; Universidade do Sul de Santa Catarina- UNISUL, Florianópolis, SC, Brazil., da Mota LMH; Hospital Universitário de Brasília, Universidade de Brasília, Brasília, DF, Brazil., Carnieletto AP; Universidade do Sul de Santa Catarina- UNISUL, Florianópolis, SC, Brazil., de Souza DGS; Universidade do Sul de Santa Catarina- UNISUL, Florianópolis, SC, Brazil., da Gama FO; Universidade do Sul de Santa Catarina- UNISUL, Florianópolis, SC, Brazil., Santos ABV; Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil., de Albuquerque CP; Hospital Universitário de Brasília, Universidade de Brasília, Brasília, DF, Brazil., Bértolo MB; Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil., Júnior PL; Universidade de São Paulo, Ribeirão Preto, SP, Brazil., Giorgi RDN; Instituto de Assistência Médica ao Servidor Público Estadual, Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil., Radominski SC; Universidade Federal do Paraná, Curitiba, PR, Brazil., Guimarães MFBR; Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil., Bonfiglioli KR; Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Sauma MFLDC; Faculdade de Medicina, Universidade Federal do Pará, Belém, PA, Brazil., Brenol CV; Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil., da Rocha Castelar Pinheiro G; Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Jazyk: angličtina
Zdroj: Advances in rheumatology (London, England) [Adv Rheumatol] 2021 Jun 25; Vol. 61 (1), pp. 38. Date of Electronic Publication: 2021 Jun 25.
DOI: 10.1186/s42358-021-00186-4
Abstrakt: Background: Rheumatoid arthritis (RA) is a common autoimmune systemic inflammatory disease. In addition to joint involvement, RA patients frequently have other comorbidities, such as cardiovascular diseases. Drugs used for RA treatment may increase or decrease the risk of a cardiovascular event. This study aims to analyze cardiovascular risk comorbidities in patients with RA and the correlation with the use of anti-rheumatic drugs.
Methods: Cross-sectional study conducted based on the real-life rheumatoid arthritis study database - REAL, a prospective observational cohort study. Associations between the use of anti-rheumatic drugs and the presence of comorbidities were represented by their prevalence ratio and evaluated using the Chi-square or Fisher's Exact tests.
Results: We assessed 1116 patients, 89.4% women, mean age of 55.15 years and predominance of seropositive disease. 63.3% had some cardiovascular comorbidity, predominantly hypertension (49.9%). The use of glucocorticoids was observed in 47.4% of patients and there was a significant tendency of lower use of these drugs in the presence of dyslipidemia (PR: 0.790; p = 0.007). We observed that the presence of cardiovascular comorbidities was associated with higher use of bDMARDs (PR:1.147; p = 0.003).
Conclusions: The presence of cardiovascular risk comorbidities was confirmed to be higher in RA patients. Different treatment strategies using less glucocorticoids in the presence of dyslipidemia and more common use of bDMARDs in patients with cardiovascular comorbidities suggest that rheumatologists are aware of the potential influence of the DMARDs in the risk of cardiovascular event. Reinforcing these results, we highlight the need for a better baseline assessment to guide the choice of anti-rheumatic drugs in RA patients who have comorbidities.
Databáze: MEDLINE
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