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Cardiovascular risk comorbidities in rheumatoid arthritis patients and the use of anti-rheumatic drugs: a cross-sectional real-life study

  • Vicente, Gustavo Nogueira Schincariol1
  • Pereira, Ivânio Alves1
  • de Castro, Gláucio Ricardo Werner1
  • da Mota, Licia Maria Henrique2
  • Carnieletto, Ana Paula1
  • de Souza, Dhara Giovanna Santin1
  • da Gama, Fabiana Oenning1
  • Santos, Ana Beatriz Vargas3
  • de Albuquerque, Cleandro Pires2
  • Bértolo, Manoel Barros4
  • Júnior, Paulo Louzada5
  • Giorgi, Rina Dalva Neubarth6
  • Radominski, Sebastião Cezar7
  • Guimarães, Maria Fernanda Brandão Resend...8
  • Bonfiglioli, Karina Rossi9
  • Sauma, Maria de Fátima Lobato da Cunha10
  • Brenol, Claiton Viegas11
  • da Rocha Castelar Pinheiro, Geraldo3
  • 1 Universidade do Sul de Santa Catarina– UNISUL, Florianópolis, SC, Brazil , Florianópolis (Brazil)
  • 2 Universidade de Brasília, Brasília, DF, Brazil , Brasília (Brazil)
  • 3 Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil , Rio de Janeiro (Brazil)
  • 4 Universidade Estadual de Campinas, Campinas, SP, Brazil , Campinas (Brazil)
  • 5 Universidade de São Paulo, Ribeirão Preto, SP, Brazil , Ribeirão Preto (Brazil)
  • 6 Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil , São Paulo (Brazil)
  • 7 Universidade Federal do Paraná, Curitiba, PR, Brazil , Curitiba (Brazil)
  • 8 Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil , Belo Horizonte (Brazil)
  • 9 Universidade de São Paulo, São Paulo, SP, Brazil , São Paulo (Brazil)
  • 10 Universidade Federal do Pará, Belém, PA, Brazil , Belém (Brazil)
  • 11 Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil , Porto Alegre (Brazil)
Published Article
Advances in Rheumatology
BioMed Central
Publication Date
Jun 25, 2021
DOI: 10.1186/s42358-021-00186-4
Springer Nature
  • Research


BackgroundRheumatoid arthritis (RA) is a common autoimmune systemic inflammatory disease. In addition to joint involvement, RA patients frequently have other comorbidities, such as cardiovascular diseases. Drugs used for RA treatment may increase or decrease the risk of a cardiovascular event. This study aims to analyze cardiovascular risk comorbidities in patients with RA and the correlation with the use of anti-rheumatic drugs.MethodsCross-sectional study conducted based on the real-life rheumatoid arthritis study database – REAL, a prospective observational cohort study. Associations between the use of anti-rheumatic drugs and the presence of comorbidities were represented by their prevalence ratio and evaluated using the Chi-square or Fisher’s Exact tests.ResultsWe assessed 1116 patients, 89.4% women, mean age of 55.15 years and predominance of seropositive disease. 63.3% had some cardiovascular comorbidity, predominantly hypertension (49.9%). The use of glucocorticoids was observed in 47.4% of patients and there was a significant tendency of lower use of these drugs in the presence of dyslipidemia (PR: 0.790; p = 0.007). We observed that the presence of cardiovascular comorbidities was associated with higher use of bDMARDs (PR:1.147; p = 0.003).ConclusionsThe presence of cardiovascular risk comorbidities was confirmed to be higher in RA patients. Different treatment strategies using less glucocorticoids in the presence of dyslipidemia and more common use of bDMARDs in patients with cardiovascular comorbidities suggest that rheumatologists are aware of the potential influence of the DMARDs in the risk of cardiovascular event. Reinforcing these results, we highlight the need for a better baseline assessment to guide the choice of anti-rheumatic drugs in RA patients who have comorbidities.

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