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银屑病关节炎中的心血管疾病与抑郁:需要多学科管理的多维共病。

Cardiovascular disease and depression in psoriatic arthritis: Multidimensional comorbidities requiring multidisciplinary management.

机构信息

Division of Rheumatology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.

Division of Rheumatology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.

出版信息

Best Pract Res Clin Rheumatol. 2021 Jun;35(2):101689. doi: 10.1016/j.berh.2021.101689. Epub 2021 May 5.

Abstract

Psoriatic arthritis (PsA) is a chronic systemic inflammatory disease. The control of joint and skin manifestations has improved tremendously with the advent of the targeted therapies in the past decade. However, the occurrence of PsA is frequently accompanied by metabolic diseases, cardiovascular diseases (CVD), and depression. They are often unrecognized or undertreated, which leads to significant morbidities and even mortality. PsA predisposes patients to these important commodities through a number of mechanisms and their complex interaction, including chronically overexpressed inflammatory cytokines, a high prevalence of traditional CVD risk factors, the impact of pharmacotherapies, and a significant psychological burden. Herein, we review and discuss evidence on the epidemiology, pathophysiology, and assessment of CVD as well as depression in patients with PsA. Lastly, a multidisciplinary management approach to this multifaceted disease is presented.

摘要

银屑病关节炎(PsA)是一种慢性全身性炎症性疾病。在过去十年中,随着靶向治疗的出现,关节和皮肤表现的控制得到了极大的改善。然而,银屑病关节炎的发生常常伴随着代谢疾病、心血管疾病(CVD)和抑郁。这些疾病经常未被识别或治疗不足,导致严重的发病率,甚至死亡率。银屑病关节炎通过多种机制及其复杂相互作用使患者易患这些重要疾病,包括慢性过度表达的炎症细胞因子、传统心血管疾病危险因素的高发、药物治疗的影响以及显著的心理负担。在此,我们回顾和讨论了银屑病关节炎患者心血管疾病和抑郁的流行病学、病理生理学和评估证据。最后,提出了一种针对这种多方面疾病的多学科管理方法。

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