Education Needed on Metabolic Risks Associated With Psoriasis

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Education Needed on Metabolic Risks Associated With Psoriasis
Education Needed on Metabolic Risks Associated With Psoriasis

Education initiatives designed for health care providers who treat patients with psoriasis are needed to help them better manage cardiovascular (CV) and metabolic risks in their patients, according to an editorial published recently in the Annals of the Rheumatic Diseases.

The subject of the editorial, written by Søren Lund Kristensen, MD, PhD, and colleagues, was a study by Alexis Ogdie-Beatty, MD, MSCE, and colleagues that reported associations between psoriasis, psoriatic arthritis and an increased risk for major adverse CV events such as myocardial infarction (MI), stroke and CV death.

This association was also noted in patients with rheumatoid arthritis (RA), and the level of severity varied among the three conditions. Closer monitoring for CV risks is needed in these patients, concluded the investigators.

However, Kristensen and colleagues questioned whether the data reported in the the recent study were sufficient to start using a CV risk multiplier in psoriasis or PsA. Instead, they suggested that educational programs may improve CV and metabolic risk management in patients.

“Such education, which does not need to be onerous, will help lessen cardiovascular risks further in their patients,” wrote the researchers.

Kristensen is with the BHF Cardiovascular Research Centre at the University of Glasgow, Glasgow, United Kingdom, and the department of cardiology at Gentofte Hospital, Copenhagen, Denmark.

The Ogdie study was the first to provide a simultaneous comparison to risk levels in RA. If the results are accepted as valid, CV risk appears to be elevated by approximately 40% to 50% for patients with RA or severe psoriasis, compared with a risk of approximately 20% for patients with psoriatic arthritis.

According to the editorial, severe psoriasis as an independent CV risk factor could reasonably be considered for inclusion in the update of the European League Against Rheumatism (EULAR) recommendations on CV risk, along with the optimal/pragmatic criteria for demarcating such patients.

However, the absolute number of events among patients with psoriatic arthritis was low, which makes it difficult to conclude the need for a risk multiplier for such patients. Additional studies are needed to determine the relative contributions of the skin disorder vs. arthralgia to vascular risk.

References

  1. Kristensen SL. Ann Rheum Dis. 2014. 2014; doi:10.1136/annrheumdis-2014-206617
  2. Ogdie G. Ann Rheum Dis. 2014; doi:10.1136/annrheumdis-2014-205675
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