Patients with rheumatoid arthritis (RA) and other inflammatory joint disorders (IJD) have increased cardiovascular disease (CVD) risk compared with the general population. In 2009, the European League Against Rheumatism (EULAR) taskforce recommended screening, identification of CVD risk factors and CVD risk management largely based on expert opinion. In view of substantial new evidence, an update was conducted with the aim of producing CVD risk management recommendations for patients with IJD that now incorporates an increasing evidence base. A multidisciplinary steering committee (representing 13 European countries) comprised 26 members including patient representatives, rheumatologists, cardiologists, internists, epidemiologists, a health professional and fellows. Systematic literature searches were performed and evidence was categorised according to standard guidelines. The evidence was discussed and summarised by the experts in the course of a consensus finding and voting process. Three overarching principles were defined. First, there is a higher risk for CVD in patients with RA, and this may also apply to ankylosing spondylitis and psoriatic arthritis. Second, the rheumatologist is responsible for CVD risk management in patients with IJD. Third, the use of non-steroidal anti-inflammatory drugs and corticosteroids should be in accordance with treatment-specific recommendations from EULAR and Assessment of Spondyloarthritis International Society. Ten recommendations were defined, of which one is new and six were changed compared with the 2009 recommendations. Each designated an appropriate evidence support level. The present update extends on the evidence that CVD risk in the whole spectrum of IJD is increased. This underscores the need for CVD risk management in these patients. These recommendations are defined to provide assistance in CVD risk management in IJD, based on expert opinion and scientific evidence.
- Cardiovascular Disease
- Rheumatoid Arthritis
- Ankylosing Spondylitis
- Psoriatic Arthritis
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Handling editor Hans WJ Bijlsma
RA, SCH, SR and MH are co-first authors.
DPMS and MTN are senior authors.
Contributors All authors participated in the activities of the EULAR task force and have provided important contributions to the manuscript.
Funding European League Against Rheumatism.
Competing interests All the participants in this initiative have disclosed any conﬂicts of interest. FA has received personal remuneration from BMS, Pfizer, MSD. IBM has received research funding or honoraria from AbbVie, BMS, Pfizer, Janssen, Novartis, Celgene, MSD, UCB and Roche. LJ has received consultancy fees or speaker honoraria from AbbVie, Actavis, Celgene, Novartis and Pfizer. GDK has received honoraria for lectures or advisory boards or hospitality from Pfizer, AbbVie, Novartis, UCB, Genesis, Roche, BMS, GSK, Eli Lilly and AstraZeneca. TKK has received fees for speaking and/or consulting from AbbVie, Biogen, BMS, Boehringer Ingelheim, Celgene, Celltrion, Eli Lilly, Epirus, Hospira, Merck-Serono, MSD, Novartis, Orion Pharma, Pfizer, Roche, Sandoz and UCB and received research funding to Diakonhjemmet Hospital from AbbVie, BMS, MSD, Pfizer, Roche and UCB. NS has consulted for Roche, Amgen, Sanofi, AstraZeneca and received grant funding from Roche. SWJ has received speaker honoraria from MSD and Pfizer. MTN has received research funding or speaking/consultancy honoraria from Abbvie, Pfizer, Merck, Roche, BMS, UCB, Eli Lilly and Janssen.
Provenance and peer review Not commissioned; externally peer reviewed.
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