Bloody Important: Atherosclerosis & Thrombotic Disease in Rheumatic Conditions

The talk by Dr. Szekanecz provided very helpful and clinically relevant information for clinicians to use in everyday practice, and the themes discussed are of great timeliness. As obesity and other risk factors for cardiovascular disease continue to increase worldwide, rheumatologists must be vigilant in screening for these conditions, and help patients not just with their autoimmune disease, but with their overall health.

Jason Liebowitz, MD, completed his fellowship in rheumatology at Johns Hopkins University, Baltimore, where he also earned his medical degree. He is currently in practice with Skylands Medical Group, N.J.

References

1. Skaggs BJ, Hahn BH, McMahon M. Accelerated atherosclerosis in patients with SLE—mechanisms and management. Nat Rev Rheumatol. 2012 Feb 14;8(4):214–223.
2. Karpouzas GA, Ormseth SR, Hernandez E, et al. Biologics may prevent cardiovascular events in rheumatoid arthritis by inhibiting coronary plaque formation and stabilizing high-risk lesions. Arthritis Rheumatol. 2020 Apr 21. Online ahead of print.
3. van Halm VP, Nurmohamed MT, Twisk JW, et al. Disease-modifying antirheumatic drugs are associated with a reduced risk for cardiovascular disease in patients with rheumatoid arthritis: A case control study. Arthritis Res Ther. 2006;8(5):R151.
4. Roubille C, Richer V, Starnino T, et al. The effects of tumour necrosis factor inhibitors, methotrexate, non-steroidal anti-inflammatory drugs and corticosteroids on cardiovascular events in rheumatoid arthritis, psoriasis and psoriatic arthritis: A systematic review and meta-analysis. Ann Rheum Dis. 2015;74(3):480–489.
5. Widdifield J, Abrahamowicz M, Paterson JM, et al. Associations between methotrexate use and the risk of cardiovascular events in patients with elderly-onset rheumatoid arthritis. J Rheumatol. 2019 May;46(5):467–474.
6. Ridker PM, Everett BM, Pradhan A, et al. Low-dose methotrexate for the prevention of atherosclerotic events. N Engl J Med. 2019 Feb 21;380(8):752–762.
7. Ridker PM, Everett BM, Thuren T, et al. Antiinflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med. 2017 Sep 21;377(12):1119–1131.
8. O’Riordan, Michael. Hopes fade for a CV indication for canakinumab: What’s next for the inflammatory hypothesis? TCTMD.com. 2019 Feb. 1.
9. Choi HK, Rho YH, Zhu Y, et al. The risk of pulmonary embolism and deep vein thrombosis in rheumatoid arthritis: A U.K. population-based outpatient cohort study. Ann Rheum Dis. 2013 Jul;72(7):1182–1187.
10. Aviña-Zubieta JA, Chan J, De Vera M, et al. Risk of venous thromboembolism in ankylosing spondylitis: A general population-based study. Ann Rheum Dis. 2019 Apr;78(4):480–485.
11. Ogdie A, Kay McGill N, Shin DB, et al. Risk of venous thromboembolism in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: A general population-based cohort study. Eur Heart J. 2018 Oct 14;39(39):3608–3614.
12. Harigai M. Growing evidence of the safety of JAK inhibitors in patients with rheumatoid arthritis. Rheumatology (Oxford). 2019 Feb 1;58(Suppl 1):i34–i42.
13. Xie W, Huang Y, Xiao S, et al. Impact of Janus kinase inhibitors on risk of cardiovascular events in patients with rheumatoid arthritis: Systematic review and meta-analysis of randomised controlled trials. Ann Rheum Dis. 2019 Aug;78(8):1048–1054.
14. Smolen JS, Landewé RBM, Bijlsma JWJ, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis. 2020 Jun;79(6):685–699.

Editor’s note: This article was updated to reflect the correct venue of the presentation, EULAR 2020, the annual European Congress of Rheumatology, which was originally scheduled to be held in Frankfurt, Germany, starting June 3, but was moved to a virtual format due to the COVID-19 pandemic.