title: EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update.
abstract: Patients with rheumatoid arthritis (RA) and other inflammatory joint disorders (IJD) have increased cardiovascular disease (CVD) risk compared with the general population. In 2009, the European League Against Rheumatism (EULAR) taskforce recommended screening, identification of CVD risk factors and CVD risk management largely based on expert opinion. In view of substantial new evidence, an update was conducted with the aim of producing CVD risk management recommendations for patients with IJD that now incorporates an increasing evidence base. A multidisciplinary steering committee (representing 13 European countries) comprised 26 members including patient representatives, rheumatologists, cardiologists, internists, epidemiologists, a health professional and fellows. Systematic literature searches were performed and evidence was categorised according to standard guidelines. The evidence was discussed and summarised by the experts in the course of a consensus finding and voting process. Three overarching principles were defined. First, there is a higher risk for CVD in patients with RA, and this may also apply to ankylosing spondylitis and psoriatic arthritis. Second, the rheumatologist is responsible for CVD risk management in patients with IJD. Third, the use of non-steroidal anti-inflammatory drugs and corticosteroids should be in accordance with treatment-specific recommendations from EULAR and Assessment of Spondyloarthritis International Society. Ten recommendations were defined, of which one is new and six were changed compared with the 2009 recommendations. Each designated an appropriate evidence support level. The present update extends on the evidence that CVD risk in the whole spectrum of IJD is increased. This underscores the need for CVD risk management in these patients. These recommendations are defined to provide assistance in CVD risk management in IJD, based on expert opinion and scientific evidence.
authors.affiliation: Departments of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade & VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Agca
authors.affiliation: Departments of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade & VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: S C
authors.identifier: http://orcid.org/0000-0002-3283-3969
authors.initials: SC
authors.lastname: Heslinga
authors.affiliation: Department of Rheumatology, Preventive Cardio-Rheuma Clinic, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: S
authors.initials: S
authors.lastname: Rollefstad
authors.affiliation: Departments of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade & VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Heslinga
authors.affiliation: College of Medical, Veterinary and Life Sciences, Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.
authors.forename: I B
authors.initials: IB
authors.lastname: McInnes
authors.affiliation: Internal and Vascular Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: M J L
authors.initials: MJ
authors.lastname: Peters
authors.affiliation: Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: T K
authors.initials: TK
authors.lastname: Kvien
authors.affiliation: Department of Rheumatology, Paris Descartes University, Hôpital Cochin. Assistance Publique, Hôpitaux de Paris INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Dougados
authors.affiliation: Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna, Vienna, Austria.
authors.forename: H
authors.initials: H
authors.lastname: Radner
authors.affiliation: IRCCS Galeazzi Orthopedic Institute, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Atzeni
authors.affiliation: Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark.|Sygehus Sønderjylland (Hospital of Southern Jutland), Aabenraa, Denmark.|King Christian 10's Hospital for Rheumatic Diseases, Graasten, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Primdahl
authors.affiliation: Department of Public Health and Clinical Medicine/Rheumatology, University of Umeå, Umeå, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Södergren
authors.affiliation: Department of Public Health and Clinical Medicine/Rheumatology, University of Umeå, Umeå, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Wallberg Jonsson
authors.affiliation: PARE (patient research partners), Sint-Joris-Weert, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: van Rompay
authors.affiliation: Romanian League Against Rheumatism (Vice-President) and Board Member (General Secretary) of AGORA, the Platform of S-E organisations for patients with RMDs, Bucharest, Romania.
authors.forename: C
authors.initials: C
authors.lastname: Zabalan
authors.affiliation: Oslo University Hospital, Ullevål, Center for Preventive Medicine and Medical Faculty, University of Oslo, Oslo, Norway.
authors.forename: T R
authors.initials: TR
authors.lastname: Pedersen
authors.affiliation: Department of Rheumatology & Inflammation Research, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg and Section of Rheumatology, Lund, Sweden.|Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Jacobsson
authors.affiliation: Department of Rheumatology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: K
authors.initials: K
authors.lastname: de Vlam
authors.affiliation: University of Cantabria, IDIVAL, Santander, Spain.
authors.forename: M A
authors.initials: MA
authors.lastname: Gonzalez-Gay
authors.affiliation: Department of Rheumatology, Preventive Cardio-Rheuma Clinic, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: A G
authors.initials: AG
authors.lastname: Semb
authors.affiliation: Head of Research and Development, Academic Affairs Dudley Group NHS Foundation Trust, Arthritis Research UK Centre for Epidemiology, University of Manchester, Russells Hall Hospital, Clinical Research Unit, Dudley, UK.
authors.forename: G D
authors.initials: GD
authors.lastname: Kitas
authors.affiliation: Internal and Vascular Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Y M
authors.initials: YM
authors.lastname: Smulders
authors.affiliation: Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, University of Debrecen, Debrecen, Hungary.
authors.forename: Z
authors.initials: Z
authors.lastname: Szekanecz
authors.affiliation: Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK.
authors.forename: N
authors.initials: N
authors.lastname: Sattar
authors.affiliation: Department of Rheumatology and Musculoskeletal Epidemiology, Arthritis Research UK Centre for Epidemiology, The University of Manchester, Manchester, UK.
authors.forename: D P M
authors.identifier: http://orcid.org/0000-0002-8625-1200
authors.initials: DP
authors.lastname: Symmons
authors.affiliation: Department of Rheumatology Reade, Amsterdam Rheumatology and Immunology Center, Reade & VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: M T
authors.initials: MT
authors.lastname: Nurmohamed
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000150:complications / Q000188:drug therapy; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D037001:Directive Counseling; D006801:Humans; D008019:Life Style; D010819:Physician's Role; D012219:Rheumatology; D018570:Risk Assessment; D012307:Risk Factors; D012308:Risk Management / Q000379:methods; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000188:drug therapy
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents
keywords: Ankylosing Spondylitis; Cardiovascular Disease; Psoriatic Arthritis; Rheumatoid Arthritis