How do you approach CV risk assessment in RA patients when RA itself is associated with some degree of increased CV risk at baseline?

Topics: Rheumatology • Rheumatoid Arthritis • General Rheumatology • Journal Club ft. NEJM publications

Recent articles regarding the use of JAK-Inhibition in RA have suggested to avoid in patients with increased CV risk. However, RA itself is considered a CV risk factor. Therefore, it seems that all RA patients would potentially be excluded from JAKi therapy. What risk factors should we really be using to determine CV risk?

Answer from: at Academic Institution

I try to screen for the CV risk factors, present or absent. If present, I use the CV risk calculator, as an example the online Framingham risk calculator, and multiply the risk by a factor of 1.5-2 as proposed by EULAR, depending on whether the RA is active or inactive. Once you have a good as...

Comments

at Tristate Arthritis & Rheumatology
Thanks, Dr. @Jasvinder Singh! This approach is ver...

Answer from: at Academic Institution

It is well established that RA is a risk factor for CV events in addition to traditional CV risk factors. RA duration and activity are associated with CV risk. All modifiable CV risk factors should be lessened as much as possible. In addition to addressing hypertension, lipid profile, weight, smokin...

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