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  • Response to: “Influence of changes in cholesterol levels and disease activity on the 10-year cardiovascular risk estimated with different algorithms in rheumatoid arthritis patients” by Fornaro et al

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Correspondence response
Response to: “Influence of changes in cholesterol levels and disease activity on the 10-year cardiovascular risk estimated with different algorithms in rheumatoid arthritis patients” by Fornaro et al
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  1. Rabia Agca1,2,
  2. Sjoerd C Heslinga1,2,
  3. S Rollefstad3,
  4. S Heslinga1,2,
  5. Anna Södergren4,
  6. AG Semb3,
  7. George D Kitas5,
  8. Naveed Sattar6,
  9. Michael T Nurmohamed1,2
  10. on behalf of The EULAR task force “EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update”
    1. 1 Department of Rheumatology, Amsterdam Rheumatology and immunology Center, location Reade, Amsterdam, The Netherlands
    2. 2 Department of Rheumatology, Amsterdam Rheumatology and immunology Center, location VU University Medical Center, Amsterdam, The Netherlands
    3. 3 Department of Rheumatology, Preventive Cardio-Rheuma Clinical, Diakonhjemmet Hospital, Oslo, Norway
    4. 4 Department of Public Health and Clinical Medicine/Rhematology, University of Umeå and Wallenberg Centre for Molecular Medicine (WCMM), Umeå University, Umeå, Sweden
    5. 5 Head of Research and Development, Academic Affairs Dudley Group NHS Foundation Trust, Arthritis Research UK Centre for Epidemiology, University of Manchester, Russells Hall Hospital, Clinical Research Unit, Dudley, UK
    6. 6 Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK
    1. Correspondence to Mrs Rabia Agca, Rheumatology, Amsterdam Rheumatology and immunology Center, location Reade and VU University Medical Center, 1081 HV Amsterdam, The Netherlands; r.agca{at}reade.nl

    https://doi.org/10.1136/annrheumdis-2019-215748

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      Fornaro and colleagues investigated the influence of cholesterol level changes and disease activity on the estimated cardiovascular (CV) risk in rheumatoid arthritis (RA) patients, at baseline, 3 months and 6 months after the start of a tumour necrosis factor-alpha (TNF) inhibitor (n=55), abatacept (n=33) or tocilizumab (n=24).1 The cohort consisted of mainly women (n=86) aged 53±13 years, with a mean disease duration of approximately 59±76 months. CV risk was calculated with QRISK3-2018, Reynolds Risk Score (RRS), Expanded Risk Score (ERS) in RA (ERS-RA) and Progetto Cuore. The Progetto Cuore and RRS scores were multiplied by 1.5 as advocated by the current EULAR recommendations.2 The authors identified a modest but statistically significant change in total cholesterol (TC) at 3 months that returned to baseline at 6 months. Additionally, the ERS-RA and RRS scores significantly decreased during follow-up, while the Progetto Cuore and QRISK3-2018 scores did not change. Thus, the authors argue that QRISK3-2018 and Proguetto Cuore can be used at any time, as they do not seem to be significantly affected by the modest changes in TC levels and disease activity.

      Several findings of this interesting study need …

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