RMD Open (Jul 2021)

Diabetes mellitus and cardiovascular risk management in patients with rheumatoid arthritis: an international audit

  • George Athanasios Karpouzas,
  • Eirik Ikdahl,
  • Silvia Rollefstad,
  • Grunde Wibetoe,
  • Anne Grete Semb,
  • Joseph Sexton,
  • Patrick Durez,
  • Maria G Tektonidou,
  • Michal Tomčík,
  • Dionicio Angel Galarza-Delgado,
  • Ian Graham,
  • Miguel A González-Gay,
  • Solbritt Rantapää-Dahlqvist,
  • Erkin M Mirrakhimov,
  • Petros P Sfikakis,
  • Virginia Pascual-Ramos,
  • Carol Hitchon,
  • Maria Simona Stoenoiu,
  • Elena Myasoedova,
  • Durga Prasanna Misra,
  • Vikas Agarwal,
  • Dimitrios Vassilopoulos,
  • Piet van Riel,
  • Bindee Kuriya,
  • George Kitas,
  • Rong Mu,
  • Anne M Kerola,
  • Karen Douglas,
  • Andrew A Borg,
  • Pompilio Faggiano,
  • Cindy Crowson,
  • Argyro Lazarini,
  • Diane Gheta,
  • Svetlana Myasoedova,
  • Lev Krougly,
  • Tatiana Valentinovna Popkova,
  • Alena Tuchyňová,
  • Michal Vrablik,
  • Pavel Horak,
  • Helena Kaspar Medkova

DOI
https://doi.org/10.1136/rmdopen-2021-001724
Journal volume & issue
Vol. 7, no. 2

Abstract

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Aim The objective was to examine the prevalence of atherosclerotic cardiovascular disease (ASCVD) and its risk factors among patients with RA with diabetes mellitus (RA-DM) and patients with RA without diabetes mellitus (RAwoDM), and to evaluate lipid and blood pressure (BP) goal attainment in RA-DM and RAwoDM in primary and secondary prevention.Methods The cohort was derived from the Survey of Cardiovascular Disease Risk Factors in Patients with Rheumatoid Arthritis from 53 centres/19 countries/3 continents during 2014–2019. We evaluated the prevalence of cardiovascular disease (CVD) among RA-DM and RAwoDM. The study population was divided into those with and without ASCVD, and within these groups we compared risk factors and CVD preventive treatment between RA-DM and RAwoDM.Results The study population comprised of 10 543 patients with RA, of whom 1381 (13%) had DM. ASCVD was present in 26.7% in RA-DM compared with 11.6% RAwoDM (p<0.001). The proportion of patients with a diagnosis of hypertension, hyperlipidaemia and use of lipid-lowering or antihypertensive agents was higher among RA-DM than RAwoDM (p<0.001 for all). The majority of patients with ASCVD did not reach the lipid goal of low-density lipoprotein cholesterol <1.8 mmol/L. The lipid goal attainment was statistically and clinically significantly higher in RA-DM compared with RAwoDM both for patients with and without ASCVD. The systolic BP target of <140 mm Hg was reached by the majority of patients, and there were no statistically nor clinically significant differences in attainment of BP targets between RA-DM and RAwoDM.Conclusion CVD preventive medication use and prevalence of ASCVD were higher in RA-DM than in RAwoDM, and lipid goals were also more frequently obtained in RA-DM. Lessons may be learnt from CVD prevention programmes in DM to clinically benefit patients with RA .