Background/Purpose:

The importance of lipid management is well recognized in rheumatic diseases. In fact, annual cardiovascular risk assessment is especially recommended for individuals with rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. The comorbid traditional cardiovascular risk factors compound the morbidity and mortality risk. Despite an abundance of data supporting that patients with rheumatic diseases have increased rates of major adverse cardiovascular events, patients are inadequately screened and often under treated.

Methods:

We conducted a retrospective study between 2013 and 2017 at the two infusion centers affiliated with the University of Arizona Arthritis Center, and identified the patients on biological infusions with comorbid cardiovascular disease, diabetes, hyperlipidemia, hypertension or smoking, and then examined whether these patients had lipid testing done and/or were on statins during this period.

Results:

Of the total 253 patients with rheumatologic diagnoses, the mean age was 62 years and 77.5% of the sample was female. 62.5% had rheumatoid arthritis, 8.7% had osteoporosis, 5.5% had systemic lupus erythematosus, 5.1% had psoriatic arthritis, 4.7% had ankylosing spondylitis, 2.8% had mixed connective tissue disease, 2.0% had juvenile idiopathic arthritis, 2.4% had anti-neutrophil cytoplasmic antibodies vasculitis, 1.6% had osteoarthritis, 0.8% had Bechet’s disease, 0.8% had dermatomyositis, 0.8% had polymyositis, 0.8% had adult-onset still’s disease, 0.4% had giant cell arteritis, 0.4% had inclusion body myositis, 0.4% had fibromyalgia, and 0.4% had gout.

Of those with a rheumatologic diagnosis and at least one qualifying co-morbid condition, 38.72% had hypertension, 30.83% had hyperlipidemia, 18.04% had diabetes, 15% were smokers, and 6.39% of patients had known cardiovascular disease. The lipid testing was performed in 40.23% of patients, and only 29.41% were on statin therapy.

Conclusion:

The findings of this study suggested that the majority of patients (60%) with rheumatic diseases lacked lipid testing, and subsequently, cardiovascular risk stratification. Given the increased cardiovascular morbidity and mortality in these patients, rheumatologists, in collaboration with primary care physicians, can ameliorate this clinical gap by ensuring that patients receive age- and disease-appropriate risk assessments. Such screening efforts may improve treatment responses and reduce the risk of adverse cardiovascular events.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/lipid-screening-and-treatment-patterns-among-patients-with-rheumatic-diseases/