Cardiometabolic comorbidities in RA and PsA: lessons learned and future directions

Nature Reviews Rheumatology, Published online: 10 July 2019; doi:10.1038/s41584-019-0256-0The relationship between inflammation, cardiovascular disease and metabolic comorbidities in rheumatoid arthritis and psoriatic arthritis is complex. Understanding these relationships is important for the management of both diseases, as cardiometabolic comorbidities place a considerable burden on these patients.
Source: Nature Reviews Rheumatology - Category: Rheumatology Authors: Source Type: research

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Date: August 26, 2019 Issue #:  1579Summary:  The FDA has required updates to the labeling of the Janus kinase (JAK) inhibitor tofacitinib(Xeljanz, Xeljanz XR) based on interim results of a postmarketing safety trial that showed an increased risk of pulmonary thromboembolism and death with a dosage of 10 mg twice daily.1 Tofacitinib is approved for treatment of rheumatoid arthritis (RA),2 psoriatic arthritis, and ulcerative colitis.In the postmarketing trial, RA patients ≥50 years old taking methotrexate who had at least one cardiovascular risk factor were randomized to receive add-on treatm...
Source: The Medical Letter - Category: Drugs & Pharmacology Authors: Source Type: research
A treat-to-target approach to psoriatic arthritis has emerged as a topic of interest following successful application of this treatment paradigm to rheumatoid arthritis. In psoriatic arthritis, this has been examined in one randomized trial to date showing benefits of a tight control treatment strategy over standard care. Nonetheless, international treatment recommendations have called for clinicians to aim for a target of remission or low disease activity, although little or no consensus exists on how to measure these targets. An ideal measure to define a treatment target should be able to address all the disease domains ...
Source: Rheumatic Disease Clinics of North America - Category: Rheumatology Authors: Source Type: research
CONCLUSION: Our study confirmed that general risk algorithms mostly underestimate and at times overestimate cardiovascular risk in rheumatic patients. We did not find studies that evaluated models for psoriasis or AS, which further demonstrates a need for research in these populations. PMID: 31416923 [PubMed - as supplied by publisher]
Source: J Rheumatol - Category: Rheumatology Authors: Tags: J Rheumatol Source Type: research
CONCLUSION: Patients with PsA have a significant economic burden on the healthcare system. Functional status is highly correlated with costs and appears to be driven mainly by the cost of secondary care consultations. Results were similar to previous studies in rheumatoid arthritis populations. PMID: 31416922 [PubMed - as supplied by publisher]
Source: J Rheumatol - Category: Rheumatology Authors: Tags: J Rheumatol Source Type: research
CONCLUSION: Based on our systematic review, the epidemiology of IMIDs among immigrants varies according to native and host countries, immigrant generation, and IMID type. The rapid evolution suggests a role for non-genetic factors and gene-environment interactions. Future studies should focus on these pattern shifts, given implications of rising global burden of IMIDs and immigration. PMID: 31351784 [PubMed - as supplied by publisher]
Source: Journal of Autoimmunity - Category: Allergy & Immunology Authors: Tags: J Autoimmun Source Type: research
AbstractAimInflammatory joint diseases (IJDs) are chronic arthritis, but frequently present with co ‐morbidities of other organs and systems, which is known as extra‐articular manifestations (EAMs). It is still unclear which clinical characteristics or bio‐markers can predict the development of EAMs. The aim of this study was to estimate the proportion of EAMs in southern Chinese patients wi th IJDs and to explore the risk factors.MethodsThis was a retrospective cohort study of a total 1135 IJDs patients, including 788 rheumatoid arthritis (RA) patients, 307 ankylosing spondylitis (AS) patients and 40 psoriatic arthr...
Source: International Journal of Rheumatic Diseases - Category: Rheumatology Authors: Tags: ORIGINAL ARTICLE Source Type: research
Conclusions: The results suggest that dose reduction can be safely performed in patients in treatment remission on a group level without compromising treatment efficacy. Subcutaneous bDMARDs, including abatacept, adalimumab, and etanercept, were observed to be well suited to customizing dosage. This study highlights the potential for individualized and personalized rheumatic medicine by providing dose reduction to individual patients, while monitoring disease activity. PMID: 31322029 [PubMed - as supplied by publisher]
Source: Scandinavian Journal of Rheumatology - Category: Rheumatology Authors: Tags: Scand J Rheumatol Source Type: research
Publication date: Available online 17 July 2019Source: Best Practice &Research Clinical RheumatologyAuthor(s): Sizheng Steven Zhao, Stephen J. Duffield, Nicola J. GoodsonAbstractFibromyalgia (FM) is one of the most common conditions that rheumatologists encounter. It is characterised by chronic widespread pain, fatigue, sleep disturbances and impaired cognition. The prevalence of comorbid FM among populations with rheumatoid arthritis (RA), axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) are considerably higher than among the general population, with pooled prevalence estimates of 18–24% in RA, 14&n...
Source: Best Practice and Research Clinical Rheumatology - Category: Rheumatology Source Type: research
Conclusion: Our meta-analysis results revealed higher cardiovascular risk in OA patients. This highlights the importance of cardiovascular risk factor management in OA.
Source: Joint Bone Spine - Category: Orthopaedics Source Type: research
Conclusion: Addition of MTX to adalimumab confers further therapeutic benefit in patients with RA, but not in those with PsA, suggesting differences in MTX effects in these two patient populations. NCT01078090, NCT01077258, NCT01111240. PMID: 31311386 [PubMed - as supplied by publisher]
Source: Scandinavian Journal of Rheumatology - Category: Rheumatology Authors: Tags: Scand J Rheumatol Source Type: research
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