Cardiovascular and disease-related features associated with extra-articular manifestations in axial spondyloarthritis. A multicenter study of 888 patients

Rueda-Gotor, Javier; Ferraz‐Amaro, Iván; Genre, Fernanda; Mazón, Iñigo González; Corrales, Alfonso; Portilla, Virginia; Llorca, Javier; Agudo-Bilbao, M.; Aurrecoechea, Elena; Expósito, Rosa; Hernández-Hernández, Vanesa; Quevedo-Abeledo, Juan Carlos; Rodríguez‐Lozano, Carlos; López-Medina, C.; Ladehesa-Pineda, Lourdes; Castañeda, Santos; Vicente, Esther; Fernández‐Carballido, Cristina; Martínez-Vidal, María Paz; Corredor, David Castro; Anino-Fernández, Joaquín; Peiteado, Diana; Plasencia-Rodríguez, Chamaida; Vivar, M. L. García; Galíndez-Agirregoikoa, E.; Pérez, Esther Montes; Díaz, Carlos Fernández; Blanco, R.

doi:10.1016/j.semarthrit.2022.152096

Cited by 8 publications

(5 citation statements)

References 37 publications

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“…As axSpA is fundamentally an inflammatory disease, controlling disease activity is important to relieve symptoms, prevent structural damage, and maintain and improve function and QoL [ 21 - 23 ]. Extra-musculoskeletal involvement is associated with decreased QoL and may be with increased cardiovascular risk and mortality [ 24 - 26 ]. Thus, controlling these symptoms in patients with axSpA is another concern.…”

Section: Recommendations For the Treatment Of Patients With Axial Spo...mentioning

confidence: 99%

Korean treatment recommendations for patients with axial spondyloarthritis

et al. 2023

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We aimed to develop evidence-based recommendations for treating axial spondylarthritis (axSpA) in Korea. The development committee was constructed, key clinical questions were determined, and the evidence was searched through online databases including MEDLINE, Embase, Cochrane, KoreaMed, and KMbase. Systematic literature reviews were conducted, quality of evidence was determined, and draft recommendations were formulated according to the Grading of Recommendations Assessment, Development, and Evaluations methodology. Recommendations that reached 80% consensus among a voting panel were finalized. Three principles and 21 recommendations were determined. Recommendations 1 and 2 pertain to treatment strategies, regular disease status assessment, and rheumatologist-steered multidisciplinary management. Recommendations 3 and 4 strongly recommend patient education, exercise, and smoking cessation. Recommendations 5~12 address pharmacological treatment of active disease using nonsteroidal anti-inflammatory drugs, glucocorticoids, sulfasalazine, biologics, and Janus kinase inhibitors. Recommendations 13~16 address treatment in stable disease. We suggest against spa and acupuncture as therapies (Recommendation 17). Recommendations 18 and 19 pertain to total hip arthroplasty and spinal surgery. Monitoring of comorbidities and drug toxicities are recommended (Recommendations 20 and 21). Recommendations for axSpA treatment in a Korean context were developed based on comprehensive clinical questions and evidence. These are intended to guide best practice in the treatment of axSpA.

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Section: Recommendations For the Treatment Of Patients With Axial Spo...mentioning

confidence: 99%

Korean treatment recommendations for patients with axial spondyloarthritis

et al. 2023

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“…As axSpA is fundamentally an inflammatory disease, controlling disease activity is important to relieve symptoms, prevent structural damage, and maintain and improve function and QoL [21][22][23]. Extra-musculoskeletal involvement is associated with decreased QoL and may be with increased cardiovascular risk and mortality [24][25][26]. Thus, controlling these symptoms in patients with axSpA is another concern.…”

Section: Overarching Principlesmentioning

confidence: 99%

Korean treatment recommendations for patients with axial spondyloarthritis

Seo

Yeo

Park

et al. 2023

Korean J Intern Med

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We aimed to develop evidence-based recommendations for treating axial spondylarthritis (axSpA) in Korea. The development committee was constructed, key clinical questions were determined, and the evidence was searched through online databases including MEDLINE, Embase, Cochrane, KoreaMed, and Kmbase. Systematic literature reviews were conducted, quality of evidence was determined, and draft recommendations were formulated according to the Grading of Recommendations Assessment, Development, and Evaluations methodology. Recommendations that reached 80% consensus among a voting panel were finalized. Three principles and 21 recommendations were determined. Recommendations 1 and 2 pertain to treatment strategies, regular disease status assessment, and rheumatologist-steered multidisciplinary management. Recommendations 3 and 4 strongly recommend patient education, exercise, and smoking cessation. Recommendations 5–12 address pharmacological treatment of active disease using nonsteroidal anti-inflammatory drugs, glucocorticoids, sulfasalazine, biologics, and Janus kinase inhibitors. Recommendations 13–16 address treatment in stable disease. We suggest against spa and acupuncture as therapies (Recommendation 17). Recommendations 18 and 19 pertain to total hip arthroplasty and spinal surgery. Monitoring of comorbidities and drug toxicities are recommended (Recommendations 20 and 21). Recommendations for axSpA treatment in a Korean context were developed based on comprehensive clinical questions and evidence. These are intended to guide best practice in the treatment of axSpA.

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“…JAKi are approved for several IMIDs that are diverse regarding their epidemiology and baseline CV risk. [48][49][50][51][52][53][54][55][56][57] Although RA, PsA, AS, UC, and axial spondylarthritis are clearly associated with CV disease, research is ongoing regarding CV risk in AA, AD, polyarticular course JIA, and vitiligo. [48][49][50][51][52][53][54][55][56][57] The heterogeneity in patient characteristics of those using JAKi in the real-world is highlighted by Table 1, which summarizes demographics in seminal phase 3 trials.…”

Section: Evidence Across Indicationsmentioning

confidence: 99%

“…48–57 Although RA, PsA, AS, UC, and axial spondylarthritis are clearly associated with CV disease, research is ongoing regarding CV risk in AA, AD, polyarticular course JIA, and vitiligo. 48–57 The heterogeneity in patient characteristics of those using JAKi in the real-world is highlighted by Table 1, which summarizes demographics in seminal phase 3 trials. Table 1 highlights the great variability in mean/median patient age, ranging from 11.9 to 57.1 years.…”

Section: The Unanswered Questions About the Cardiovascular Safety Pro...mentioning

confidence: 99%

Cardiovascular Risk Management in Patients Treated With Janus Kinase Inhibitors

Shah,

Femia

et al. 2024

Journal of Cardiovascular Pharmacology

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The Janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathway plays a critical role in the pathogenesis of many immune-mediated inflammatory diseases (IMIDs). Although Janus kinase inhibitors (JAKi) are an effective treatment for several IMIDs, they have come under scrutiny as a class due to a potential risk of venous thromboembolism (VTE) and cardiovascular (CV) events, specifically noted with the oral JAKi, tofacitinib, as reported in the ORAL Surveillance Trial of a high CV risk rheumatoid arthritis population. This trial resulted in a black box warning from the Food and Drug Administration and European Medicines Agency regarding risk of VTE and CV events that was extended across several types of JAKi (including topical ruxolitinib) when treating IMIDs, leading to considerable controversy. Included is an up-to-date review of the current and rapidly evolving literature on CV risk in patients with IMIDs on JAKi therapy, including identification of potential risk factors for future VTE and CV events on JAKi therapy. We suggest a comprehensive, multimodal, and systematic approach for evaluation of CV risk in patients considering taking JAKi and emphasize that cardiologists play an important role in risk stratification and mitigation for patients with high CV risk factors or on long-term JAKi therapies.

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Cardiovascular and disease-related features associated with extra-articular manifestations in axial spondyloarthritis. A multicenter study of 888 patients

Cited by 8 publications

References 37 publications

Korean treatment recommendations for patients with axial spondyloarthritis

Korean treatment recommendations for patients with axial spondyloarthritis

Korean treatment recommendations for patients with axial spondyloarthritis

Cardiovascular Risk Management in Patients Treated With Janus Kinase Inhibitors

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