Increased Risk of Cardiovascular Disease May be Easing in Patients With PsA

Patients with psoriatic arthritis (PsA) and spondylarthritis (SpA) have an increased risk of incident cardiovascular disease (CVD) compared with the general population, but that risk appears to be decreasing among patients with PsA. Researchers published the findings, which stemmed from a meta-analysis of longitudinal studies, in the journal Rheumatology.

The risk among patients with SpA did not seem to be lower in this analysis.

“This result is of major importance, as it may indicate that, in addition to the global improvement of CVD management in the general population, recent progress in medical care of PsA, including earlier diagnosis and more efficient treatments, has led not only to improved control of disease activity, but also to decreased occurrence of CVD risk,” wrote corresponding author Maria Antonietta D’Agostino, MD, PhD, of Università Cattolica del Sacro Cuore,  Roma, Italy, and study coauthors.

Researchers performed a systematic literature review of 34 controlled observational studies, with recent data and follow-up periods of 5 years or more, to assess the incidence of CVD over time in patients with SpA and PsA compared with the general population. Of the reviewed studies, 24 were selected for meta-analysis.

The meta-analysis found an increased incidence of CVD both in patients with PsA and those with SpA. Compared with the general population, hazard ratios for CVD were 1.28 in patients with PsA and 1.45 in patients with SpA, according to the study.

By specific cardiovascular outcome, hazard ratios were 1.54 for ischemic heart disease, 1.32 for stroke, and 1.16 for cardiovascular death in patients with PsA compared with the general population. In patients with SpA, hazard ratios were 1.49 for ischemic heart disease, 1.47 for stroke, and 1.38 for cardiovascular death compared with the general population.

“Further longitudinal studies are required to precisely determine the potential effect of anti-rheumatic drugs in SpA/PsA patients, including interventional studies and strategic trials,” researchers wrote. “These studies may help to determine whether the risk of incident CVD can be lowered or even corrected in patients with current treat-to-target management.”

Reference

Gouze H, Aegerter P, Gouyette Y, Breban M, D’Agostino MA. Risk of cardiovascular disease decreases over time in psoriatic arthritis but not in spondylarthritis: meta-analysis of longitudinal studies. Rheumatology. 2024;63(10):2638-2647. doi:10.1093/rheumatology/keae080