CVD drugs underused for patients with inflammatory joint disease

WASHINGTON — Cardiovascular disease-preventing medicines were infrequently used among patients with inflammatory joint disease, according to a study performed by researchers in Norway and presented at the American College of Rheumatology Annual Meeting.

“Patients with inflammatory joint diseases [(IJD)] have an increased risk for cardiovascular diseases and this has been known for 2 [decades] or 3 decades,” Anne Grete Semb, MD, PhD, in the Department of Rheumatology at Diakonhjemmet Hospital in Oslo, said in her presentation. “Despite this, it appears that these patients are undertreated.”

Anne Grete Semb

Using the Norwegian Collaboration on Cardiovascular Disease in Patients with Rheumatic Joint Diseases (NOCAR) cohort, Semb and colleagues collected cardiovascular disease (CVD) risk factors from 2,647 patients. Of these, 1,696 had rheumatoid arthritis (RA); 445 had ankylosing spondylitis (AS); 376 had psoriatic arthritis (PsA) and 130 had other spondyloarthropathies. Researchers defined the need for anti-hypertensives as a blood pressure greater than or equal to 140/90 mmHg or self-reported hypertension. Using Systemic Coronary Risk Evaluation (SCORE), they estimated the 10-year risk for a fatal CVD event. Guidelines recommended lipid lowering therapy (LLT) for patients with diabetes, hyperlipidemia or a SCORE level of at least 5% until the patient’s LDL cholesterol drops below 2.6 mmol/L or below 1.8 mmol/L for a SCORE of at least 10%. After adjusting for age and sex, the researchers compared LLT usage among those with and without IJD.

Researchers found indications for anti-hypertensives in 53.2% of all patients, in 57% of patients with RA and in 57.2% of patients with (PsA). Among patients indicated for anti-hypertensives, 59% received it and half of these patients reached their goal blood pressure.

Researchers found indications for LLTs in 24.1% of patients, which was significantly lower in the AS group (14.4%). Of the LLT-indicated patients, 55.6% had a SCORE of at least 5% and 43.7% had a SCORE of at least 10%. About half of indicated patients received LLT, and 16.8% reached LDL treatment targets.

“There is a huge need for improving both initiation of the CVD risk assessment and of forming better goal attainment and better treatment for CVD prevention,” Semb said. – by Will Offit

Reference:

Semb AG, et al. Abstract #1477. Presented at: American College of Rheumatology Annual Meeting; Nov. 11-16, 2016; Washington.

Disclosure: One researcher reported funds from Go Treat IT.