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Cardiovascular risk in patients with spondyloarthritis and association with anti-TNF drugs

Shirley Chiu Wai Chan1, Cheong Kay Teo2, Philip Hei Li1

  • 1Division of Rheumatology and Clinical Immunology, The University of Hong Kong, Hong Kong.

Therapeutic Advances in Musculoskeletal Disease
|August 11, 2021
PubMed

Insights

Spondylarthritis (SpA) significantly increases cardiovascular disease risk, independent of other factors. Anti-tumor necrosis factor (TNF) therapy shows promise in reducing these cardiovascular events in SpA patients.

Area of Science:

  • Rheumatology
  • Cardiovascular Medicine
  • Epidemiology

Background:

  • Cardiovascular diseases (CVS) are a leading global cause of mortality.
  • Patients with rheumatic diseases, including spondylarthritis (SpA), face elevated cardiovascular risk.
  • Cardiovascular risk factors and events are prevalent in SpA patients.

Purpose of the Study:

  • To delineate cardiovascular risk in patients with SpA.
  • To identify modifiable risk factors for cardiovascular events in SpA.
  • To compare cardiovascular event incidence between SpA and non-specific back pain (NSBP) cohorts.

Main Methods:

  • A cohort study comparing 5046 SpA patients with 2430 NSBP patients.
  • Age- and sex-matched analysis of clinical information and cardiovascular events.
  • Propensity score adjustment and Cox regression to assess SpA-associated cardiovascular risk.

Main Results:

  • SpA patients exhibited higher prevalence of hypercholesterolemia and increased incidence of major adverse cardiovascular events (MACE) and stroke.
  • Spondylarthritis (SpA) was identified as an independent risk factor for MACE (HR 1.70) and cerebrovascular events (HR 1.50).
  • Anti-tumor necrosis factor (TNF) therapy was associated with significantly reduced MACE and cerebrovascular event risk in SpA patients.

Conclusions:

  • Spondylarthritis (SpA) is an independent risk factor for cardiovascular disease.
  • Anti-tumor necrosis factor (TNF) therapy demonstrates a protective effect against cardiovascular events in SpA patients.
  • Further research into cardiovascular risk management in SpA is warranted.
Abstract

Keywords:
cardiovascular eventcerebrovascular eventmyocardial infarctionspondyloarthritisstroke

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