Cardiovascular risk in patients with psoriatic arthritis


Cite item

Full Text

Abstract

Psoriatic arthritis (PsA) is a chronic immune-mediated disease that is observed in 8-30% of psoriatic patients. It has been recently established that PsA and psoriasis are closely associated with the high prevalence of metabolic syndrome, hypertension, abdominal obesity, and a risk for cardiovascular diseases (CVD), including fatal myocardial infarction (MI) and acute cerebrovascular accidents, which shortens lifespan in the patients compared to the general population. The authors state their belief that the synergic effect of traditional risk factors (RFs) for CVD and systemic inflammation underlie the development of atherosclerosis in PsA. It is pointed out that the risk of CVD may be reduced not only provided that the traditional RFs for CVD are monitored, but also systemic inflammation is validly suppressed. The cardioprotective abilities of methotrexate and tumor necrosis factor-α (TNF-α) inhibitors are considered; the data of investigations showing that the treatment of PsA patients with TNF-α inhibitors results in a reduction in carotid artery intima-media thickness are given. It is noted that there is a need for the early monitoring of traditional RFs for CVD in patients with PsA and for the elaboration of interdisciplinary national guidelines.

References

  1. Koolaee RM, Takeshita J, Ogdie A. Epydemiology and natural history of psoriatic arthritis: an update. Curr Derm Rep. 2013;2:66-76.
  2. Mehta NN, Yu Y, Saboury B, Foroughi N, Krishnamoorthu P, Raper A, Baer A, Antigua J, Van Voorhees AS, Torgian DA, Alavi A, Gelfand JM. Systemic and vascular inflammation in patients with moderate to severe psoriasis as measured by [18F]-fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT): a pilot study. Arch Dermatol. 2011;147(9):1031-1039. doi: 10.1001/archdermatol.2011.119.
  3. Miller IM, Ellervik C, Yazdanyar S, Jemec GB. Meta-analysis of psoriasis, cardiovascular disease, and associated risk factors. J Am Acad Dermatol. 2013;69(6):1014-24. doi: 10.1016/j.jaad.2013.06.053.
  4. Haraoui B, Liu PP, Papp KA. Managing cardiovascular risk in patients with chronic inflammatory diseases. Clin Rheumatol. 2012;31(4):585-594. doi: 10.1007/s10067-011-1921-0.
  5. Friedewald VE, Cather JC, Gordon KB, Kavanaugh A, Ridker PM, Roberts WC. The editor’s roundtable: psoriasis, inflammation, and coronary artery disease. Am J Cardiol. 2008;102(12):1631-1643. doi: 10.1016/j.amjcard.2008.10.004.
  6. Zhu TY, Li EK, Tam LS. Cardiovascular risk in patients with psoriatic arthritis. Int J Rheumatol. 2012;2012:714321. doi: 10.1155/2012/714321.
  7. Tobin AM, Veale DJ, Fitzgerald O, Rogers S, Collins P, O’Shea D, Kirby B. Cardiovascular disease and risk factors in patients with psoriasis and psoriatic arthritis. J Rheumatol. 2010;37(7):1386-1394. doi: 10.3899/jrheum.090822.
  8. Peters MJ, van der Horst-Bruinsma IE, Dijkmans BA, Nurmohamed MT. Cardiovascular risk profile of patients with spondylarthropathies, particularly ankylosing spondylitis and psoriaticarthritis. Semin Arthritis Rheum. 2004;34(3):585-592.
  9. Mathieu S, Motreff P, Soubrier M. Spondyloarthropathies: an independent cardiovascular risk factor? Joint Bone Spine. 2010;77(6):542-545. doi: 10.1016/j.jbspin.2010.05.001.
  10. Roman MJ, Salmon JE. Cardiovascular manifestations of rheumatologic diseases. Circulation. 2007;116:2346-2355.
  11. Gladman DD, Ang M, Su L, Tom BDM, Schentag CT, Farewell VT. Cardiovascular morbidity in psoriatic arthritis. Ann Rheum Dis. 2009;68(7):1131-1135. doi: 10.1136/ard.2008.094839.
  12. Ahlehoff O, Gislason GH, Charlot M, Jurgensen CH, Lindhardsen J, Olesen JB, Abildstrom SZ, Skov L, Torp-Pedersen C, Hansen PR. Psoriasis is associated with clinically significant cardiovascular risk: a Danish nationwide cohort study. J Intern Med. 2011;270(2):147-157. doi: 10.1111/j.1365-2796.2010.02310.x.
  13. Armstrong EJ, Harskamp CT, Armstrong AW. Psoriasis and major adverse cardiovascular events: a systemic review and meta-analysis of observational studies. J Am Heart Assoc. 2013;2(2):e000062. doi: 10.1161/JAHA.113.000062.
  14. Ahlehoff O, Skov I, Gislason G, Gniadecki R, Iversen L, Bryld LE, Lasthein S, Lindhardsen J, Kristensen SL, Torp-Pedersen C, Hansen PR. J EurAcad Dermatol Venerol. 2015;29(6):1128-1134. doi: 10.1111/jdv.12768.
  15. Angel K, Provan SA, Gulseth HL, Mowinckel P, Kvien TK, Atar D. Tumor necrosis factor-α antagonists improve aortic stiffness in patients with inflammatory arthropathies: a controlled study. Hypertension. 2010;55(2):333-338. doi: 10.1161/HYPERTENSIONAHA.109.143982.
  16. Peters MJ, Symmons DP, McCarey D, Dijkmans BA, Nicola P, Kvien TK, McInnes IB, Haentzschel H, Gonzalez-Gay MA, Provan S, Semb A, Sidiropoulos P,Kitas G, Smulders YM, Soubrier M, Szekanecz Z, Sattar N, Nurmohamed MT. EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis. Ann Rheum Dis. 2010;69(2):325-331. doi: 10.1136/ard.2009.113696.
  17. Boehncke WH, Boehncke S, Tobin AM, Kirby B. The «psoriatic march»: a concept of how severe psoriasis may drive cardiovascular comorbidity. Exp Dermatol. 2011;20(4):303-307. doi: 10.1111/j.1600-0625.2011.011.01261.x5666.
  18. Fitzgerald R, Sadlier M, Connoly M, Tobin AM. Psoriasis and insulin resistance: a review. Diabetes Res Clin Metab. 2014. doi:10.7243?2050-0866-3-3.
  19. Tam LS, Shang Q, Li EK, Tomlinson B, Chu TT, Li M, Leung YY, Kwok LW, Wong KC, Li TK, Yu T, Zhu TY, Kun EW, Yip GW, Yu CM. Subclinical carotid atherosclerosis in patients with psoriatic arthritis. Arthritis Rheum. 200815;59(9):1322-1331. doi: 10.1002/art.24014.
  20. Eder L, Zisman D, Barzilai M, Laor A, Rahat M, Rozenbaum M, Bitterman H, Feld J, Rimar D, Rosner I. Subclinical atherosclerosis in psoriatic arthritis: a case-control study. J Rheumatol. 2008;35(5):877-882.
  21. Ramonda R, Lo Nigro A, Modesti V, Nalotto L, Musacchio E, Iaccarino L, Punzi L, Doria A. Atherosclerosis in psoriatic arthritis. Autoimmun Rev. 2011;10(12):773-778. doi: 10.1016/j.autrev.2011.05.022.
  22. Costa L, Caso F, D’Elia L, Atteno M, Peluso R, Del Puente A, Strazzullo P, Scarpa R. Psoriatic arthritis is associated with increased arterial stiffness in the absence of known cardiovascular risk factors: a case control study. Clin Rheumatol. 2012;31(4):711-715. doi: 10.1007/s10067-011-1892-1.
  23. Rose S, Jenny D, Millo C, Naik HB, Siegel E, Mehta NN. Psoriatic arthritis and sacroiliitis are associated with increased vascular inflammation by 18-fluorodeoxyglucose positron emission computed tomography: baseline report from Psoriasis Atherosclerosis and Cardiometaboloc Disease Initiative. Arthritis Res Ther. 2014;16:R161.
  24. Buckley C, Cavill C, Taylor G, Kay H, Waldron N, Korendowych E, McHugh N. Mortality in psoriatic arthritis — a single-center study from the UK. J Rheumatol. 2010;37(10):2141-2144. doi: 10.3899/jrheum.100034.
  25. Wong K, Gladman DD, Husted J, Long JA, Farewell VT. Mortality studies in psoriatic arthritis: results from a single centre. I. Risk and causes of death. Arthritis Rheum. 1997;40(10):1868-1872.
  26. Li WQ, Han JL, Manson JE, Rimm EB, Rexrode KM, Curhan GC, Qureshi AA. Psoriasis and risk of nonfatal cardiovascular disease in U.S. women: a cohort study. Br J Dermatol. 2012;166(4):811-817. doi: 10.1111/j.1365-2133.2011.10774.x.
  27. Shen J, Shang Q, Li E. Cumulative inflammatory burden is independently associated with increased artherial stiffness in patients with psoriatic arthritis: a prospective study. Arthritis Res Ther. 2015;17:75. doi: 10.1186/s13075-015-0570-0.
  28. Khraishi M, MacDonald D, Rampakakis E, Vaillancourt J, Sampalis JS. Prevalence of patient-reported comorbidities in early and established psoriatic arthritis cohorts. 97. Clin Rheumatol. 2011;30(7): 877-885. doi: 10.1007/s10067-011-1692-7.
  29. Tam LS, Tomlinson B, Chu TT, Li M, Leung YY, Kwok LW, Li TK, Yu T, Zhu YE, Wong KC, Kun EW, Li EK. Cardiovascular risk profile of patients with psoriatic arthritis compared to controls — the role of inflammation. Rheumatology. 2008;47(5):718-723. doi: 10.1093/rheumatology/ken090.
  30. Han C, Robinson DW, Hackett MV, Paramore LC, Fraeman KH, Bala MV. Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. J Rheumatol. 2006;33:2167-1272.
  31. Mok CC, Ko GTC, Ho LY, Yu KL, Chan PT, To CH. Prevalence of atherosclerotic risk factors and the metabolic syndrome in patients with chronic inflammatory arthritis. Arthritis Care Res (Hoboken). 2011;63(2):195-202. doi: 10.1002/acr.20363.
  32. Thornton CC, Al-Rashed Аl- Calay D, Birdsey GM, Bauer A, Mylroie H, Morley BJ, Randi AM, Haskard DO, Boyle JJ, Mason JC. Methotrexate-mediated activation of an AMPK-CREB-dependent pathway: a novel mechanism for vascular protection in chronic systemic inflammation. Ann Rheum Dis Published Online First on January 9, 2015. doi: 10.1136/annrheumdis-2014-206305.
  33. Di Minno MN, Iervolino S, Peluso R, Scarpa R, Di Minno G. Carotid intima-Media-Thickness in Psoriatic Arthritis. Differences between tumor necrosis factor alpha blocers and traditional disease-modifying antirheumatic drugs. Arterioscler Thromb Vasc Biol. 2011;31(3):705-712. doi: 10.1161/ATVBAHA.110.214585.
  34. Strober BE, Clay Cather J, Cohen D, Crowley JJ, Gordon KB, Gottlieb AB, Kavanaugh AF, Korman NJ, Krueger GG, Leonardi CL, Schwartzman S, Sobell JM,Solomon GE, Young M. A Delphy consensus approach to challenging case scenarios in moderate-to-severe psoriasis: Part 2. Dermatol Ther (Heidelb). 2012;2(1):2. doi: 10.1007/s13555-012-0002-x.
  35. Angel K, Provan SA, Gulseth HL, Mowinckel P, Kvien TK, Atar D. Tumor necrosis factor-alpha antagonists improve aortic stiffness in patients with inflammatory arthropathies: a controlled study. Hypertension. 2010;55(2):333-338. doi: 10.1161/Hypertensionaha.109.143982.
  36. Reich K, Langley RG, Lebwohl M. Cardiovascular safety of ustekinumab in patients with moderate to severe psoriasis: results of integrated analyses of data from phase 2 and 3 clinical studies. Br J Dermatol. 2011;164(4):862-872. doi: 10.1111/j.1365-2133.2011.10257.x.
  37. Di Minno MN, Peluso R, Iervolino S, Lupoli R, Russolillo A, Tarantino G, Scarpa R. Hepatic steatosis, carotid plaques and achieving MDA in psoriatic arthritis patients starting TNF alpha treatment: a prospective study. Arthritis Res Ther. 2012;14:R211. doi: 10.1186/ar4049.
  38. Pathirana D, Ormerod AD, Saiag P, Smith C, Spuls PI, Nast A, Barker J, Bos JD, Burmester GR, Chimenti S, Dubertret L, Eberlein B, Erdmann R, Ferguson J, Girolomoni G, Gisondi P, Giunta A, Griffiths C, Hinigsmann H, Hussain M, Jobling R, Karvonen SL, Kemeny L, Kopp I, Leonardi C, Maccarone M, Menter A,Mrowietz U, Naldi L, Nijsten T, Ortonne JP, Orzechowski HD, Rantanen T, Reich K, Reytan N, Richards H, Thio HB, van de Kerkhof P, Rzany B. European S3-guidelines on systemic treatment of psoriasis vulgaris. J Eur AcadDermatol Venereol. 2009;23 Suppl 2:1-70. doi: 10.1111/j.1468-3083.2009.03389.x.
  39. Кragballe K, Zachariae Е, Zacharlae H. Methotrexate in psoriatic arthritis: А retrospective study. Acta Derm Venereol. 1983;63(2):165-1657.
  40. Ceponis A, Kavanaugh A. Use of methotrexate in patients with psoriatic arthritis. Clin Exp Rheumatol. 2010;28(5)Suppl. 61:132-137.
  41. Chandran V, Schentag CT, Gladman DD. Reappraisal of the effectiveness of methotrexate in psoriatic arthritis: results from a longitudinal observational cohort. J Rheumatol. 2008;35(3):469-471.
  42. Helliwell PS, Taylor W. Treatment of psoriatic arthritis and rheumatoid arthritis with disease modifying drugs — comparison of drugs and adverse reactions. J Rheumatol. 2008;35(3):472-476.
  43. Lacaille D, Stein HB, Raboud J, Klinlhoff AV. Longterm therapy of psotiatic arthritis: intramuscular gold or methotrexate? J Rheumatol. 2000;27(8):1922-1927.
  44. Ricci M, De Marco G, Desiati F, Mazzocchi D, Rotunno L, Battafarano N, Marchesoni A. Long-term survival of methotrexate in psoriatic arthritis. Reumatismo. 2009;61(2):125-131.
  45. Odgie A, Yu Yi, Haynes K, Love T, Maliha S, Jiang Y, Toxel A, Hennessy S, Kimmel S, Margolis D, Choi H, Mehta N, Gelfand J. Risk of major cardiovascular events in patients with psoriatic, psoriasis and rheumatoid arthritis: a population-based cohort study. Ann Rheum Dis. 2014;10:1-7. doi: 10.1136/annrheumdis-2014-205675.
  46. Hoekstra M, Haagsma C, Neef C, Proost J, Knuif A, van de Laar M. Bioavailability of high dose methotrexate comparing oral and subcutaneous administration in patients with rheumatoid arthritis. J Rheumatol. 2004;31(4):645-648.
  47. Dalrymple JM, Stamp LK, O’Donnell JL, Chapman PT., Zhang M, Barclay ML. Pharmacokinetics of oral methotrexate in patients with rheumatoid arthritis. Arthritis Rheum. 2008;58(11):3299-3208. doi: 10.1002/art.24034.
  48. Stamp LK, Barclay ML, O’Donnell JL, Zhang M, Drake J, Frampton C, Chapman PT. Effects of changing from oral to subcutaneous methotrexate on red blood cell methotrexate polyglutamate concentrations and disease activity in patients with rheumatoid arthritis. J Rheumatol. 2011;38(12):2540-2547. doi: 10.3899/jrheum.110481.
  49. Schiff MH, Simon LS, Freundlich B. Drug exposure limitations of oral methotrexate (MTX) at doses >15 mgs may be over-come by using a subcutaneous MTX auto-injector in patients with rheumatoid arthritis (RA). Arthritis Rheum. 2013;65(Suppl):337-339.
  50. Yazici Y, Bata Y. Parenteral methotrexate for the treatment of rheumatoid arthritis. Bull Hosp Jt Dis. 2013;71(Suppl 1):46-48.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2016 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Managing Editor:

  • Tel.: +7 (926) 905-41-26
  • E-mail: e.gorbacheva@ter-arkhiv.ru

 

 © 2018-2021 "Consilium Medicum" Publishing house


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies