Impact of cardiovascular risk factors on the achievement of therapeutic goals in psoriatic arthritis: is there any association?

Clin Rheumatol. 2018 Mar;37(3):661-666. doi: 10.1007/s10067-018-4004-7. Epub 2018 Jan 29.

Abstract

Cardiovascular risk factors (CVRFs) have been related to poorer responses to systemic therapy in psoriatic arthritis (PsA). We aimed to evaluate the potential association between CVRFs and the achievement of therapeutic goals in PsA patients receiving systemic therapy. A cross-sectional study was carried out at 25 rheumatology outpatient clinics in Spain. PsA patients with established disease who were treated with conventional and biologic systemic therapies were included. The treatment goals measured were minimal disease activity (MDA) and very low disease activity (VLDA) responses. The relationship between MDA/VLDA and CVRFs was evaluated by uni- and multivariate models. Of a total of 227 patients, 133 (58.6%) and 26 (11.5%) patients were in MDA and VLDA, respectively. Tobacco use (crude OR 0.54), sedentary lifestyle (crude OR 1.95), hyperuricemia (crude OR 2.01) and obesity (crude OR 1.54) were related to the likelihood of MDA in the univariate model (p < 0.25), while in multivariate analysis, a sedentary lifestyle (OR 3.13, 95%CI 1.50-6.53; p = 0.002) increased the odds of having reached MDA. Obesity (crude OR 2.2) and dyslipidaemia (crude OR 1.80) were associated with VLDA in univariate analysis, whereas dyslipidaemia (OR 5.3, 95%CI 1.7-16.6; p = 0.004) increased the odds of VLDA in the multivariate model. We found no association between the number of CVRFs and the MDA/VLDA responses. In this cross-sectional, multicentre study, we could not find any relationship between CVRFs and lower odds of achieving stringent therapeutic goals in PsA. In any case, patients with psoriatic disease should be encouraged to maintain healthy lifestyle habits.

Keywords: Cardiovascular risk factors; Psoriasis; Psoriatic arthritis (PsA).

MeSH terms

  • Adult
  • Aged
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Psoriatic / complications
  • Arthritis, Psoriatic / drug therapy*
  • Cardiovascular Diseases / complications*
  • Cross-Sectional Studies
  • Female
  • Goals*
  • Humans
  • Male
  • Middle Aged
  • Remission Induction
  • Risk Factors
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Antirheumatic Agents