Spondyloarthritis is associated with excess mortality.
Signs of subclinical atheroma develop early in patients with active spondyloarthritis.
TNFα antagonists have not been proven effective in improving the vascular abnormalities seen in patients with spondyloarthritis.
Ankylosing spondylitis (AS) is a chronic inflammatory joint disease that involves the entheses, causing inflammatory pain and functional impairments. Patients may experience extraarticular manifestations such as uveitis, psoriasis, and inflammatory bowel disease. These, together with the increased risk of cardiovascular disease and osteoporosis and the development of spinal fusion, are the main determinants of adverse disease outcomes. As with many systemic inflammatory diseases, AS is associated with excess cardiovascular mortality due to increased risks of myocardial infarction, stroke, and venous thromboembolism. Studies of markers for subclinical atheroma (endothelial dysfunction, arterial stiffness, and intima-media thickness) have shown earlier onset of arterial disease compared to healthy controls, with the difference being greatest for patients with active AS. The potential vascular effects of drugs used to treat AS have not been established. Few studies have focused on nonsteroidal antiinflammatory drugs and biologics in patients with AS, and their results do not conclusively establish a beneficial or deleterious effect in axial spondyloarthritis. Statins have been found to improve endothelial dysfunction and to decrease mortality. The latest EULAR recommendations on cardiovascular risk management in patients with inflammatory joint disease indicate that statins should be used in compliance with national guidelines.Le texte complet de cet article est disponible en PDF.
Keywords : Spondyloarthritis, Artery, Cardiovascular, Vessels, Endothelium, Mortality
Vol 86 - N° 2P. 159-163 - mars 2019 Retour au numéro
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement ou un achat à l’unité.
L'accès au texte intégral de cet article nécessite un abonnement ou un achat à l'unité.