title: Management of dyslipidaemia in high-risk patients with recent-onset rheumatoid arthritis: targets still not met despite specific recommendations. Results from the ESPOIR cohort during the first five years of follow-up.
abstract: OBJECTIVE
  Reduction of LDL-cholesterol (LDLc) is essential to decrease the cardiovascular mortality in rheumatoid arthritis (RA). Between 2005 and 2010, French recommendations for dyslipidaemia defined the LDLc target based on the number of cardiovascular risk factors. In 2006, it was recommended to consider LDLc objectives with RA being counted as an additional cardiovascular risk factor. Our objective was to assess lipid target achievement between 2006 and 2010 in a cohort of patients with recent-onset RA.
  
  
  METHODS
  814 patients were included between 2002 and 2005 in a French cohort of patients with early arthritis and a high probability of RA (ESPOIR). Repeated cross-sectional analyses for cardiovascular risk factors, cholesterol levels were performed every year from 2006 to 2010 to determine lipid profile and achievement of the LDLc goal according to the French guidelines.
  
  
  RESULTS
  On the 620 patients analysed at the first point, 77% were female, 89.8% fulfilled the ACR criteria for RA and 2.7% received a statin. The proportion of patients failing to achieve the LDLc target did not improve following the publication of specific RA guidelines in 2006 (15.3 to 22.5% between 2006 and 2010). In patients with the highest cardiovascular risk, more than 58% did not reach the LDLc target.
  
  
  CONCLUSIONS
  Specific recommendations for RA published in 2006 decreased LDLc target but did not improve management of dyslipidaemia in daily life which remained suboptimal particularly in patients at highest risk.
authors.affiliation: Rheumatology Department, CHU Clermont-Ferrand; and UNH-UMR 1019, INRA and University of Auvergne, Clermont-Ferrand, France. atournadre@chu-clermontferrand.fr.
authors.forename: Anne
authors.initials: A
authors.lastname: Tournadre
authors.affiliation: Biostatistic Unit (DRCI), CHU Clermont-Ferrand, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Pereira
authors.affiliation: Rheumatology Department, CHU Clermont-Ferrand, France.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Dubost
authors.affiliation: Lapeyronie Hospital, Montpellier I University, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Rincheval
authors.affiliation: Rheumatology Department, CHU de Nancy, Université de Lorraine, Université Paris Descartes, Apemac, Vandoeuvre-lès-Nancy, France.
authors.forename: Anne Christine
authors.initials: AC
authors.lastname: Rat
authors.affiliation: Rheumatology Department, Lapeyronie Hospital, Montpellier University, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Combe
authors.affiliation: Rheumatology Department, CHU Clermont-Ferrand, France.
authors.forename: Martin
authors.initials: M
authors.lastname: Soubrier
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D005602:France; D019983:Guideline Adherence; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D015415:Biomarkers; D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents; D008055:Lipids