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Observational Study
. 2021 Jun 25;61(1):38.
doi: 10.1186/s42358-021-00186-4.

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

Gustavo Nogueira Schincariol Vicente  1 , Ivânio Alves Pereira  2 , Gláucio Ricardo Werner de Castro  2 , Licia Maria Henrique da Mota  3 , Ana Paula Carnieletto  2 , Dhara Giovanna Santin de Souza  2 , Fabiana Oenning da Gama  2 , Ana Beatriz Vargas Santos  4 , Cleandro Pires de Albuquerque  3 , Manoel Barros Bértolo  5 , Paulo Louzada Júnior  6 , Rina Dalva Neubarth Giorgi  7 , Sebastião Cezar Radominski  8 , Maria Fernanda Brandão Resende Guimarães  9 , Karina Rossi Bonfiglioli  10 , Maria de Fátima Lobato da Cunha Sauma  11 , Claiton Viegas Brenol  12 , Geraldo da Rocha Castelar Pinheiro  4
Affiliations
Observational Study

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

Gustavo Nogueira Schincariol Vicente et al. Adv Rheumatol. .

Abstract

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.

Keywords: Cardiovascular diseases; Rheumatoid arthritis; Treatment.

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References

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