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Prevalence of cardiovascular disease and major risk factors in patients with rheumatoid arthritis: a multinational cross-sectional study

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Pappas DA1,2, Nyberg F3,4, Kremer JM5, Lampl K6, Reed GW7,8, Horne L9, Ho M10, Onofrei A7, Malaviya AN11, Rillo OL12, Radominski SC13, Gal J14, Gibofsky A15, Popkova TV16, Laurindo L17, Kerzberg EM18, Zahora R19, Pons-Estel BA20, Curtis JR21, Furst DE22, Greenberg JD7,23. Clin Rheumatol. 2018 Apr 25. doi: 10.1007/s10067-018-4113-3. [Epub ahead of print]

Abstract

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1Columbia University College of Physicians and Surgeons, New York, NY, USA. dpappas@corrona.org.

2 Corrona LLC, Southborough, MA, USA. dpappas@corrona.org.

3 Medical Evidence and Observational Research Centre, Global Medicines Development, AstraZeneca R&D, Mölndal, Sweden.

4 Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

5 Albany Medical College and The Center for Rheumatology, Albany, NY, USA.

6 Genentech Inc., South San Francisco, CA, USA.

7 Corrona LLC, Southborough, MA, USA.

8 University of Massachusetts Medical School, Worcester, MA, USA.

9 Medical Evidence and Observational Research Centre, Global Medicines Development, AstraZeneca R&D, Wilmington, DE, USA.

10 Clinical, Global Medicines Development, AstraZeneca R&D, Alderley Park, UK.

11 ISIC Super Specialty Hospital, New Delhi, India.

12 Hospital I. Pirovano, Buenos Aires, Argentina.

13 Universidade Federal do Paraná and CETI, Curitiba, Brazil.

14 County Hospital, Kecskemét, Hungary.

15 Hospital for Special Surgery-Weill Medical College of Cornell University, Ithaca, New York, USA.

16 Nasonova Research Institute of Rheumatology, Moscow, Russia.

17 University Nove De Julho, São Paulo, Brazil.

18 JM Ramos Mejía Hospital, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.

19 Revmatologická Ambulance, Terezín, Czech Republic.

20 Cardiovascular Institute of Rosario, Rosario, Argentina.

21 University of Alabama at Birmingham, Birmingham, AL, USA.

22 David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

23 NYU School of Medicine, New York, NY, USA.

Abstract

To compare the prevalence of cardiovascular disease (CVD) and major CVD risk factors among rheumatoid arthritis (RA) patients enrolled in a large US and multinational registry. We compared CVD and CVD risk factor prevalence from 11 countries enrolled in the CORRONA US and CORRONA International registries; patients from the 10 ex-US participating countries were grouped by region (Eastern Europe, Latin America, and India). Unadjusted summary data were presented for demographics and disease characteristics; comparisons for prevalence of CVD risk factors and CVD were age/gender standardized to the age/gender distribution of the US enrolled patients. Overall, 25,987 patients were included in this analysis. Compared to patients from the ex-US regions, US participants had longer disease duration and lower disease activity, yet were more likely to receive a biologic agent. Additionally, CORRONA US participants had the highest body mass index (BMI). Enrolled patients in India had the lowest BMI, were more rarely smokers, and had a low prevalence of hyperlipidemia, hypertension, and prior CVD compared to the US and other ex-US regions. Participants from Eastern Europe had a higher prevalence of hypertension and hyperlipidemia and highest prevalence of all manifestations of CVD. Differences in the prevalence of both CVD and major CVD risk factors were observed across the four regions investigated. Observed differences may be influenced by variations in both non-modifiable/modifiable characteristics of patient populations, and may contribute to heterogeneity on the observed safety of investigational and approved therapies in studies involving RA patients from different origins.