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Joint Bone Spine
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le mercredi 19 février 2020
Doi : 10.1016/j.jbspin.2019.12.004
Received : 22 July 2019 ;  accepted : 3 December 2019
Cardiovascular risk in psoriatic arthritis, a narrative review
 

Frank Verhoeven a, b, , Clément Prati a, b, Céline Demougeot b, Daniel Wendling a, c
a Service de rhumatologie, CHRU de Besanço, 25030 Besançon cedex, France 
b EA 4267 « PEPITE », université de Bourgogne Franche-Comté, 25000 Besançon, France 
c EA 4266 «EPILAB », université de Bourgogne Franche-Comté, 25000 Besançon,France 

Corresponding author. Rhumatologie, CHRU Jean Minjoz, 2, boulevard Fleming, 25030 Besançon, France.Rhumatologie, CHRU Jean Minjoz2, boulevard FlemingBesançon25030France
Abstract
Introduction

Psoriatic arthritis (PsA) is a chronic inflammatory rheumatism characterized for a long time by a high degree of cardiovascular risk. Chronic inflammation is one of the mechanisms that explain this cardiovascular excess of risk through direct and indirect pathways. In recent years, epidemiological data have changed somewhat since the increasing use of bio-drugs that are effective in reducing this inflammation. The purpose of this review is to assess the current state of cardiovascular morbidity and mortality in PsA and thus to assess the cardiovascular risk in case of PsA.

Method

We conducted a literature review using Pubmed and Medline databases with the following keywords “Psoriatic Arthritis” AND “cardiovascular” including articles from the last three years.

Results

It appears that in case of PsA, there is an increased prevalence of high blood pressure, diabetes, obesity and dyslipidemia, and therefore of metabolic syndrome. Insulin resistance is closely linked to PsA. On the other hand, the data are more contrasted for active smoking. There is also arterial inflammation specific to PsA. Finally, at the therapeutic level, the impact of NSAIDs remains controversial, while methotrexate and bio-drugs are beneficial at the cardiovascular level.

Conclusion

PsA is characterized by an increase in cardiovascular morbidity in relation with insulin resistance. Current treatments seem to improve this risk with a decrease in cardiovascular mortality in comparison with patients with plaque psoriasis but this requires confirmation in larger prospective studies.

The full text of this article is available in PDF format.

Keywords : Psoriatic arthritis, Cardiovascular risk, Atherosclerosis




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