Alexis Ogdie1, YiDing Yu2, Kevin Haynes3, Thorvardur Jon Love4, Samantha Maliha5, Yihui Jiang6, Andrea B Troxel3, Sean Hennessy3, Steven E Kimmel7, David J Margolis8, Hyon Choi9, Nehal N Mehta10, Joel M Gelfand11. 1. Division of Rheumatology, Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. 2. Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA. 3. Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. 4. University of Iceland, Reykjavik, Iceland. 5. New York University School of Medicine, New York, NY, USA. 6. Division of Rheumatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. 7. Department of Medicine, Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Center for Therapeutic Effectiveness Research, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. 8. Department of Dermatology, Center for Clinical Epidemiology and Biostatistics, Center for Dermatoepidemiology and Translation, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. 9. Section of Rheumatology and the Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts, USA. 10. Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA. 11. Department of Dermatology, Center for Clinical Epidemiology and Biostatistics, Center for Dermatoepidemiology and Translation, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Abstract
OBJECTIVES: We aimed to quantify the risk of major adverse cardiovascular events (MACE) among patients with psoriatic arthritis (PsA), rheumatoid arthritis (RA) and psoriasis without known PsA compared with the general population after adjusting for traditional cardiovascular risk factors. METHODS: A population-based longitudinal cohort study from 1994 to 2010 was performed in The Health Improvement Network (THIN), a primary care medical record database in the UK. Patients aged 18-89 years of age with PsA, RA or psoriasis were included. Up to 10 unexposed controls matched on practice and index date were selected for each patient with PsA. Outcomes included cardiovascular death, myocardial infarction, cerebrovascular accidents and the composite outcome (MACE). Cox proportional hazards models were used to calculate the HRs for each outcome adjusted for traditional risk factors. A priori, we hypothesised an interaction between disease status and disease-modifying antirheumatic drug (DMARD) use. RESULTS: Patients with PsA (N=8706), RA (N=41 752), psoriasis (N=138 424) and unexposed controls (N=81 573) were identified. After adjustment for traditional risk factors, the risk of MACE was higher in patients with PsA not prescribed a DMARD (HR 1.24, 95% CI 1.03 to 1.49), patients with RA (No DMARD: HR 1.39, 95% CI 1.28 to 1.50, DMARD: HR 1.58, 95% CI 1.46 to 1.70), patients with psoriasis not prescribed a DMARD (HR 1.08, 95% CI 1.02 to 1.15) and patients with severe psoriasis (DMARD users: HR 1.42, 95% CI 1.17 to 1.73). CONCLUSIONS: Cardiovascular risk should be addressed with all patients affected by psoriasis, PsA or RA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
OBJECTIVES: We aimed to quantify the risk of major adverse cardiovascular events (MACE) among patients with psoriatic arthritis (PsA), rheumatoid arthritis (RA) and psoriasis without known PsA compared with the general population after adjusting for traditional cardiovascular risk factors. METHODS: A population-based longitudinal cohort study from 1994 to 2010 was performed in The Health Improvement Network (THIN), a primary care medical record database in the UK. Patients aged 18-89 years of age with PsA, RA or psoriasis were included. Up to 10 unexposed controls matched on practice and index date were selected for each patient with PsA. Outcomes included cardiovascular death, myocardial infarction, cerebrovascular accidents and the composite outcome (MACE). Cox proportional hazards models were used to calculate the HRs for each outcome adjusted for traditional risk factors. A priori, we hypothesised an interaction between disease status and disease-modifying antirheumatic drug (DMARD) use. RESULTS:Patients with PsA (N=8706), RA (N=41 752), psoriasis (N=138 424) and unexposed controls (N=81 573) were identified. After adjustment for traditional risk factors, the risk of MACE was higher in patients with PsA not prescribed a DMARD (HR 1.24, 95% CI 1.03 to 1.49), patients with RA (No DMARD: HR 1.39, 95% CI 1.28 to 1.50, DMARD: HR 1.58, 95% CI 1.46 to 1.70), patients with psoriasis not prescribed a DMARD (HR 1.08, 95% CI 1.02 to 1.15) and patients with severe psoriasis (DMARD users: HR 1.42, 95% CI 1.17 to 1.73). CONCLUSIONS: Cardiovascular risk should be addressed with all patients affected by psoriasis, PsA or RA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: James D Lewis; Rita Schinnar; Warren B Bilker; Xingmei Wang; Brian L Strom Journal: Pharmacoepidemiol Drug Saf Date: 2007-04 Impact factor: 2.890
Authors: Joel M Gelfand; Erica D Dommasch; Daniel B Shin; Rahat S Azfar; Shanu K Kurd; Xingmei Wang; Andrea B Troxel Journal: J Invest Dermatol Date: 2009-05-21 Impact factor: 8.551
Authors: Tim Doran; Catherine Fullwood; Hugh Gravelle; David Reeves; Evangelos Kontopantelis; Urara Hiroeh; Martin Roland Journal: N Engl J Med Date: 2006-07-27 Impact factor: 91.245
Authors: Jürgen Braun; Klaus Krüger; Bernhard Manger; Matthias Schneider; Christof Specker; Hans Joachim Trappe Journal: Dtsch Arztebl Int Date: 2017-03-24 Impact factor: 5.594
Authors: George Martin; Bruce E Strober; Craig L Leonardi; Joel M Gelfand; Andrew Blauvelt; Arthur Kavanaugh; Linda Stein Gold; Brian Berman; Ted Rosen; Eggert Stockfleth Journal: J Clin Aesthet Dermatol Date: 2016-09-01
Authors: Alexis Ogdie; Neilia Kay McGill; Daniel B Shin; Junko Takeshita; Thorvardur Jon Love; Megan H Noe; Zelma C Chiesa Fuxench; Hyon K Choi; Nehal N Mehta; Joel M Gelfand Journal: Eur Heart J Date: 2018-10-14 Impact factor: 29.983
Authors: Kashif Jafri; Christie M Bartels; Daniel Shin; Joel M Gelfand; Alexis Ogdie Journal: Arthritis Care Res (Hoboken) Date: 2016-11-28 Impact factor: 4.794