Key clinical point: Cardiovascular disease incidence and prevalence were higher among inflammatory arthritis patients with a second autoimmune disorder than in patients with inflammatory arthritis only or healthy controls.

Major finding: The hazard ratio for cardiovascular disease was 1.32 for patients with inflammatory arthritis and 1.49 for those with both inflammatory arthritis and another autoimmune disorder.

Study details: The data come from 28,345 inflammatory arthritis patients and 28,249 matched controls collected from the NIVEL (Netherlands Institute for Health Services Research) primary care database in the Netherlands.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Commentary

The association RA with increased risk of cardiovascular disease is well-recognized, with increasing focus on early detection and diagnosis of other cardiovascular risk factor in RA patients. This study examined a primary care database of over 1.5 million patients in the Netherlands and identified 28,345 patients with inflammatory arthritis (including RA, PsA, and AS). Compared to controls, 13.5% of inflammatory arthritis patients vs. 7.3% of non-inflammatory arthritis patients had one or more other autoimmune disorders (including type I diabetes, hypothyroidism, psoriasis, multiple sclerosis, and inflammatory bowel disease), and those patients with more than autoimmune disorder had a higher prevalence of cardiovascular disease. The significance of these findings is not entirely clear, as psoriasis is highly associated with psoriatic arthritis, and the risk of cardiovascular disease is increased in patients with type I diabetes. However, the suggestion of a possible clustering of autoimmune conditions with RA is interesting, as is the authors’ suggestion that their registry may comprise patients with lower disease activity (under the care of primary care physicians) who still have an elevated risk of cardiovascular disease.—Arundathi Jayatilleke, MD