Rheumatology Division, Hospital Universitario Central de Asturias, Avenida de Roma s/n, 33011, Oviedo, Spain.
Rheumatology Division, Arthritis Unit, Hospital Clinic, Barcelona, Spain.
Clin Rheumatol. 2018 Mar;37(3):661-666. doi: 10.1007/s10067-018-4004-7. Epub 2018 Jan 29.
Cardiovascular risk factors (CVRFs) have been related to poorer responses to systemic therapy in psoriatic arthritis (PsA). We aimed to evaluate the potential association between CVRFs and the achievement of therapeutic goals in PsA patients receiving systemic therapy. A cross-sectional study was carried out at 25 rheumatology outpatient clinics in Spain. PsA patients with established disease who were treated with conventional and biologic systemic therapies were included. The treatment goals measured were minimal disease activity (MDA) and very low disease activity (VLDA) responses. The relationship between MDA/VLDA and CVRFs was evaluated by uni- and multivariate models. Of a total of 227 patients, 133 (58.6%) and 26 (11.5%) patients were in MDA and VLDA, respectively. Tobacco use (crude OR 0.54), sedentary lifestyle (crude OR 1.95), hyperuricemia (crude OR 2.01) and obesity (crude OR 1.54) were related to the likelihood of MDA in the univariate model (p < 0.25), while in multivariate analysis, a sedentary lifestyle (OR 3.13, 95%CI 1.50-6.53; p = 0.002) increased the odds of having reached MDA. Obesity (crude OR 2.2) and dyslipidaemia (crude OR 1.80) were associated with VLDA in univariate analysis, whereas dyslipidaemia (OR 5.3, 95%CI 1.7-16.6; p = 0.004) increased the odds of VLDA in the multivariate model. We found no association between the number of CVRFs and the MDA/VLDA responses. In this cross-sectional, multicentre study, we could not find any relationship between CVRFs and lower odds of achieving stringent therapeutic goals in PsA. In any case, patients with psoriatic disease should be encouraged to maintain healthy lifestyle habits.
心血管风险因素(CVRFs)与银屑病关节炎(PsA)患者全身治疗反应较差有关。我们旨在评估 CVRFs 与接受全身治疗的 PsA 患者达到治疗目标之间的潜在关联。在西班牙的 25 个风湿病门诊进行了一项横断面研究。纳入了患有已确诊疾病且正在接受传统和生物全身治疗的 PsA 患者。测量的治疗目标是疾病活动度最低(MDA)和疾病活动度极低(VLDA)反应。通过单变量和多变量模型评估 MDA/VLDA 与 CVRFs 之间的关系。在总共 227 名患者中,133 名(58.6%)和 26 名(11.5%)患者达到 MDA 和 VLDA。在单变量模型中,吸烟(粗 OR 0.54)、久坐不动的生活方式(粗 OR 1.95)、高尿酸血症(粗 OR 2.01)和肥胖(粗 OR 1.54)与 MDA 的可能性相关(p < 0.025),而在多变量分析中,久坐不动的生活方式(OR 3.13,95%CI 1.50-6.53;p = 0.002)增加了达到 MDA 的几率。肥胖(粗 OR 2.2)和血脂异常(粗 OR 1.80)在单变量分析中与 VLDA 相关,而血脂异常(OR 5.3,95%CI 1.7-16.6;p = 0.004)在多变量模型中增加了达到 VLDA 的几率。我们没有发现 CVRFs 数量与 MDA/VLDA 反应之间的关系。在这项横断面、多中心研究中,我们没有发现 CVRFs 与银屑病关节炎患者更难达到严格治疗目标之间存在任何关联。在任何情况下,都应鼓励患有银屑病的患者保持健康的生活习惯。