Prompted by the fact that rheumatoid arthritis and two other rheumatic diseases are as strong risk factors as type 2 diabetes for cardiovascular disease (CVD), the European League Against Rheumatism (EULAR) task force has issued the group's first consensus recommendations for managing cardiovascular risk in patients with rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. Designation of these diseases by a EULAR panel is the first time that a major medical group has singled out these conditions in this way.

     According to Dr. Michael T. Nurmohamed, a rheumatologist at the Free University Medical Center in Amsterdam, cardiovascular risk management is absolutely necessary in patients with those three diseases. The management should involve assessing and treating cardiovascular disease risk factors as well as suppressing the underlying inflammatory process with disease-modifying antirheumatic drugs (DMARDs).

     An annual cardiovascular disease risk assessment following EULAR guidelines is recommended for all rheumatoid arthritis patients, should be considered for all ankylosing spondylitis and psoriatic arthritis patients, and should be repeated if antirheumatic treatment changes. The assessment should be initiated by the patient's rheumatologist. It may be done by the rheumatologist, a cardiologist, or a primary care physician with an interest in cardiovascular disease.

     "The increased CVD risk in patients with inflammatory arthritis is now well recognized," Dr. Nurmohamed says. He added that the extent to which the new guidelines are already routinely followed by rheumatologists and other physicians is variable. In some countries, CVD risk management in patients with rheumatoid diseases is uncommon.

--Source: Excerpted from "EULAR Issues Guidance on CVD Risk Reduction," Rheumatology News, July 2009