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Psoriatic Arthritis and Metabolic Syndrome: Is There a Role for Disease Modifying Anti-Rheumatic Drugs?

Although psoriatic arthritis (PsA) primarily leads to joint and skin damage, it is associated with higher prevalence of metabolic syndrome (MetS) and its components, namely hypertension, dyslipidemia, obesity, and type II diabetes. Additionally, chronic inflammation is known to aggravate these cardi...

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Autores principales: Atzeni, Fabiola, Gerratana, Elisabetta, Francesco Masala, Ignazio, Bongiovanni, Sara, Sarzi-Puttini, Piercarlo, Rodríguez-Carrio, Javier
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8435605/
https://www.ncbi.nlm.nih.gov/pubmed/34527685
http://dx.doi.org/10.3389/fmed.2021.735150
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author Atzeni, Fabiola
Gerratana, Elisabetta
Francesco Masala, Ignazio
Bongiovanni, Sara
Sarzi-Puttini, Piercarlo
Rodríguez-Carrio, Javier
author_facet Atzeni, Fabiola
Gerratana, Elisabetta
Francesco Masala, Ignazio
Bongiovanni, Sara
Sarzi-Puttini, Piercarlo
Rodríguez-Carrio, Javier
author_sort Atzeni, Fabiola
collection PubMed
description Although psoriatic arthritis (PsA) primarily leads to joint and skin damage, it is associated with higher prevalence of metabolic syndrome (MetS) and its components, namely hypertension, dyslipidemia, obesity, and type II diabetes. Additionally, chronic inflammation is known to aggravate these cardiometabolic factors, thus explaining the enhanced cardiovascular (CV) morbidity and mortality in RA. Furthermore, emerging evidence suggest that some risk factors can fuel inflammation, thus pointing to a bidirectional crosstalk between inflammation and cardiometabolic factors. Therefore, dampening inflammation by disease-modifying anti-rheumatic drugs (DMARDs) may be thought to ameliorate MetS burden and thus, CV risk and disease severity. In fact, recommendations for PsA management emphasize the need of considering comorbidities to guide the treatment decision process. However, the existing evidence on the impact of approved DMARDs in PsA on MetS and MetS components is far from being optimal, thus representing a major challenge for the clinical setting. Although a beneficial effect of some DMARDs such as methotrexate, TNF inhibitors and some small molecules is clear, no head-to-head studies are published and no evidence is available for other therapeutic approaches such as IL-23 or IL-17 inhibitors. This narrative review summarizes the main evidence related to the effect of DMARDs on MetS outcomes in PsA patients and identify the main limitations, research needs and future perspectives in this scenario.
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spelling pubmed-84356052021-09-14 Psoriatic Arthritis and Metabolic Syndrome: Is There a Role for Disease Modifying Anti-Rheumatic Drugs? Atzeni, Fabiola Gerratana, Elisabetta Francesco Masala, Ignazio Bongiovanni, Sara Sarzi-Puttini, Piercarlo Rodríguez-Carrio, Javier Front Med (Lausanne) Medicine Although psoriatic arthritis (PsA) primarily leads to joint and skin damage, it is associated with higher prevalence of metabolic syndrome (MetS) and its components, namely hypertension, dyslipidemia, obesity, and type II diabetes. Additionally, chronic inflammation is known to aggravate these cardiometabolic factors, thus explaining the enhanced cardiovascular (CV) morbidity and mortality in RA. Furthermore, emerging evidence suggest that some risk factors can fuel inflammation, thus pointing to a bidirectional crosstalk between inflammation and cardiometabolic factors. Therefore, dampening inflammation by disease-modifying anti-rheumatic drugs (DMARDs) may be thought to ameliorate MetS burden and thus, CV risk and disease severity. In fact, recommendations for PsA management emphasize the need of considering comorbidities to guide the treatment decision process. However, the existing evidence on the impact of approved DMARDs in PsA on MetS and MetS components is far from being optimal, thus representing a major challenge for the clinical setting. Although a beneficial effect of some DMARDs such as methotrexate, TNF inhibitors and some small molecules is clear, no head-to-head studies are published and no evidence is available for other therapeutic approaches such as IL-23 or IL-17 inhibitors. This narrative review summarizes the main evidence related to the effect of DMARDs on MetS outcomes in PsA patients and identify the main limitations, research needs and future perspectives in this scenario. Frontiers Media S.A. 2021-08-30 /pmc/articles/PMC8435605/ /pubmed/34527685 http://dx.doi.org/10.3389/fmed.2021.735150 Text en Copyright © 2021 Atzeni, Gerratana, Francesco Masala, Bongiovanni, Sarzi-Puttini and Rodríguez-Carrio. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Atzeni, Fabiola
Gerratana, Elisabetta
Francesco Masala, Ignazio
Bongiovanni, Sara
Sarzi-Puttini, Piercarlo
Rodríguez-Carrio, Javier
Psoriatic Arthritis and Metabolic Syndrome: Is There a Role for Disease Modifying Anti-Rheumatic Drugs?
title Psoriatic Arthritis and Metabolic Syndrome: Is There a Role for Disease Modifying Anti-Rheumatic Drugs?
title_full Psoriatic Arthritis and Metabolic Syndrome: Is There a Role for Disease Modifying Anti-Rheumatic Drugs?
title_fullStr Psoriatic Arthritis and Metabolic Syndrome: Is There a Role for Disease Modifying Anti-Rheumatic Drugs?
title_full_unstemmed Psoriatic Arthritis and Metabolic Syndrome: Is There a Role for Disease Modifying Anti-Rheumatic Drugs?
title_short Psoriatic Arthritis and Metabolic Syndrome: Is There a Role for Disease Modifying Anti-Rheumatic Drugs?
title_sort psoriatic arthritis and metabolic syndrome: is there a role for disease modifying anti-rheumatic drugs?
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8435605/
https://www.ncbi.nlm.nih.gov/pubmed/34527685
http://dx.doi.org/10.3389/fmed.2021.735150
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