scholarly journals Therapeutic strategies for reduction of the cardiovascular risk in patients with inflammatory joint diseases

2017 ◽  
Vol 3 (1) ◽  
pp. 35
Author(s):  
Ivan Gruev ◽  
Tzvetomir Delyiski ◽  
Jivko Kolev
Keyword(s):  
Cardiovascular Risk ◽  
Therapeutic Strategies ◽  
Joint Diseases ◽  
Inflammatory Joint Diseases

scholarly journals Mechanisms and Mediators of Pain in Chronic Inflammatory Arthritis

2021 ◽  
Author(s):  
Marco Di Carlo ◽  
Gianluca Smerilli ◽  
Fausto Salaffi
Keyword(s):  
Inflammatory Pain ◽  
Inflammatory Arthritis ◽  
Operational Definition ◽  
Immunosuppressive Drugs ◽  
Therapeutic Strategies ◽  
Future Research ◽  
Common Symptom ◽  
Joint Diseases ◽  
Chronic Inflammatory Arthritis ◽  
Inflammatory Joint Diseases

Abstract Purpose of the review Pain in chronic inflammatory joint diseases is a common symptom reported by patients. Pain becomes of absolute clinical relevance especially when it becomes chronic, i.e., when it persists beyond normal healing times. As an operational definition, pain is defined chronic when it lasts for more than 3 months. This article aims to provide a review of the main mechanisms underlying pain in patients with chronic inflammatory joint diseases, discussing in particular their overlap. Recent findings While it may be intuitive how synovial inflammation or enthesitis are responsible for nociceptive pain, in clinical practice, it is common to find patients who continue to complain of symptoms despite optimal control of inflammation. In this kind of patients at the genesis of pain, there may be neuropathic or nociplastic mechanisms. Summary In the context of chronic inflammatory joint diseases, multiple mechanisms generally coexist behind chronic pain. It is the rheumatologist’s task to identify the mechanisms of pain that go beyond the nociceptive mechanisms, to adopt appropriate therapeutic strategies, including avoiding overtreatment of patients with immunosuppressive drugs. In this sense, future research will have to be oriented to search for biomarkers of non-inflammatory pain in patients with chronic inflammatory joint diseases.

scholarly journals Unmet needs in the management of cardiovascular risk in inflammatory joint diseases

2019 ◽  
Vol 16 (1) ◽  
pp. 23-36 ◽  
Author(s):  
Santos Castañeda ◽  
Esther F. Vicente-Rabaneda ◽  
Noelia García-Castañeda ◽  
Diana Prieto-Peña ◽  
Patrick H. Dessein ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Unmet Needs ◽  
Joint Diseases ◽  
Inflammatory Joint Diseases

Guideline recommended treatment to targets of cardiovascular risk is inadequate in patients with inflammatory joint diseases

2019 ◽  
Vol 274 ◽  
pp. 311-318 ◽  
Author(s):  
Eirik Ikdahl ◽  
Grunde Wibetoe ◽  
Silvia Rollefstad ◽  
Anne Salberg ◽  
Kjetil Bergsmark ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Joint Diseases ◽  
Inflammatory Joint Diseases ◽  
Recommended Treatment

scholarly journals Treatment to lipid targets in patients with inflammatory joint diseases in a preventive cardio-rheuma clinic

2012 ◽  
Vol 72 (12) ◽  
pp. 1968-1974 ◽  
Author(s):  
Silvia Rollefstad ◽  
Tore K Kvien ◽  
Ingar Holme ◽  
Anne S Eirheim ◽  
Terje R Pedersen ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Risk Stratification ◽  
Unmet Need ◽  
Density Lipoprotein ◽  
Cardiovascular Prevention ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Joint Diseases ◽  
Cardiovascular Risk Stratification ◽  
Inflammatory Joint Diseases

ObjectivesTo perform cardiovascular risk stratification in patients with inflammatory joint diseases (IJD) and treat to lipid targets according to recommendations.MethodsWe initiated a preventive cardio-rheuma clinic based on the unmet need of adequate cardiovascular prevention in IJD patients. A full cardiovascular risk stratification was performed at the first consultation (history of conventional risk factors and of cardiovascular disease, lipid measurement, blood pressure and ultrasound examination of both carotid arteries), and the patient was classified to either a primary or secondary cardiovascular prevention regime, or to have a low risk (no intervention). Lipid-lowering treatment was adjusted until at least two lipid targets were achieved.ResultsOf the 426 patients referred, 36.6% had a systematic coronary risk evaluation less than 5% (no lipid-lowering intervention). The remaining 270 patients ((rheumatoid arthritis (RA), n=165; ankylosing spondylitis (AS), n=70; and psoriatic arthritis (PsA), n=35) were assigned to either primary (n=63) or secondary prevention (n=207). There were significant differences between the patient groups regarding age (p<0.001), sex (p<0.001) and disease duration (p<0.001). Lipid changes in IJD patients were: total cholesterol −1.86±1.20 mmol/l (p<0.001); low-density lipoprotein cholesterol −1.74±1.11 (p<0.001); high-density lipoprotein cholesterol 0.01±0.30 (p=0.61); triglycerides −0.28±0.72 (p<0.001). The proportions of patients reaching at least two lipid targets were for RA 92.1%, AS 90.0% and PsA 82.9%. No serious adverse events were observed.ConclusionsThere was indication for cardiovascular prevention in a high proportion of IJD patients referred for cardiovascular risk stratification. Treatment to lipid targets was successful in approximately 90% of patients with IJD.

Cardiovascular Disease in Spondyloarthritides

2020 ◽  
Vol 18 (5) ◽  
pp. 473-487 ◽  
Author(s):  
Charalampos Papagoras ◽  
Paraskevi V. Voulgari ◽  
Alexandros A. Drosos
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Healthcare Providers ◽  
Cardiovascular Death ◽  
Point Of View ◽  
Treat To Target ◽  
Inflammatory Joint Diseases ◽  
Scientific Organizations ◽  
Increased Risk ◽  
Risk Patients

The spondyloarthritides are a group of chronic systemic inflammatory joint diseases, the main types being ankylosing spondylitis (AS) and psoriatic arthritis (PsA). Evidence accumulating during the last decades suggests that patients with AS or PsA carry an increased risk for cardiovascular disease and cardiovascular death. This risk appears to be mediated by systemic inflammation over and above classical cardiovascular risk factors. The excess cardiovascular risk in those patients has been formally acknowledged by scientific organizations, which have called physicians’ attention to the matter. The application by Rheumatologists of new effective anti-rheumatic treatments and treat-to-target strategies seems to benefit patients from a cardiovascular point of view, as well. However, more data are needed in order to verify whether anti-rheumatic treatments do have an effect on cardiovascular risk and whether there are differences among them in this regard. Most importantly, a higher level of awareness of the cardiovascular risk is needed among patients and healthcare providers, better tools to recognize at-risk patients and, ultimately, commitment to address in parallel both the musculoskeletal and the cardiovascular aspect of the disease.

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