Frequency of dyslipidemia and compliance with the treatment in psa patients using bdmards

BackgroundDyslipidemia is the leading treatable-modifiable factor among comorbidities in Psoriatic arthritis (PsA) patients. International treatment recommendations have left the management of dyslipidemia to national guidelines and especially to the rheumatologists.ObjectivesIn this study, we aimed to determine the frequency of dyslipidemia and the rates of initiation of treatment within the indication in PsA patients using bDMARDs.MethodsThe Hacettepe University biological database (HUR-BIO), was established in 2005 and data of 520 PsA patients included until 2021 were analyzed. In all included patients, the diagnosis of PsA was made by therheumatologist. Lipid profiles of PsA patients were evaluated at diagnosis, during the first bDMARD initiation, and at the last visit. Total cholesterol (TC), Triglyserides (TG), HDL-C and LDL-C values were grouped as optimal, borderline, high and severely high according to the Turkish Endocrine and Metabolism society criteria (1).ResultsLipid profile values ​​of PsA patients were known at diagnosis (n=159, 30.6%), in the initial bDMARD baseline (n=161, 30.9%), and at the last visit (n=203, 39.0%). The time to diagnosis of PsA and first bDMARD use was 2.8 years, and the time between the start of bDMARD and the last visit was 3.7 years. Accordingly, the rates of high TC, borderline TG, and high LDL increased over time. Rates at the time of PsA diagnosis, first bDMARD onset and at the last visit are as follows; high TC (14.3%, 17.1% and 28.0%), borderline TG (20.4%, 27.7% and 40.5%) and high LDL (17.0, 24.0% and 27.9%). On the other hand, low HDL-C slightly improved in men (33.3%, 29.4% and 23.1%), but did not show a significant change in women. While LDL-C level was >160 in 24.0% of patients who were started on bDMARD, anti-hyperlipidemic drug was started in only 6.2% of them. A similar situation persisted at the last visit (27.9% had LDL-C levels >160, but 10.8% received anti-hyperlipidemic therapy) (Table 1).Table 1.Lipid levels and changes over timeLipid levelsAt the time of diagnosis n= 159At the time of bDMARD initiation n=161bDMARD last visit n= 203Total Cholesterol (TC) mean (SD)195 (42)201 (43)214 (47)- TC < 200 (optimal) (%)56.552.845.3- TC 200-239 (borderline) (%)27.230.125.7-- TC > 240 (high) (%)14.317.128.0Triglyceride (TG) mean (SD)115 (52)132 (90)158 (103)- TG < 150 (optimal) (%)79.671.758.0- TG 150-499 (borderline) (%)20.427.740.5- TG 500-880 (high) (%)001.0-- TG ≥ 880 (severely high) (%)00.60.5HDL-C mean (SD)51.8 (13.1)50.6 (13.0)53.2 (12.5)- ≥60 (optimal) (%)20.620.425.6- 40-59 (borderline) in men (%)54.660.852.3- 50-59 (borderline) in women (%)32.324.530.3- Male < 40 (low) (%)33.329.423.1-- Women < 50 (low) (%)32.339.633.8LDL-C mean (SD)126 (33)132 (37)139 (36)- LDL-C < 100 (optimal) (%)21.421.114.2- LDL 130-159 (borderline) (%)22.525.127.0- LDL 160-190 (high) (%)17.024.027.9-- LDL > 190 (very high) (%)4.46.38.4Anti-hyperlipidemic drug n (%)5 (3.1)10 (6.2)22 (10.8)ConclusionAmong the modifiable risk factors for cardiovascular comorbidities in PsA patients, the leading risk factor is dyslipidemia. On the other hand, dyslipidemic drug use rates in daily practice are significantly lower. Although attention is paid to the management of comorbidities in all recommendations, there is still work to be done in real life.References[1]TEMD Obezite, L.M., Hipertansiyon Çalişma Grubu, TEMD DİSLİPİDEMİ TANI VE TEDAVİ KILAVUZU. 9 ed, ed. 2021, Ankara: Türkiye Endokrinoloji ve Metabolizma Derneği. 159.Disclosure of InterestsNone declared