• Fabio Cacciapaglia, Francesca Romana Spinelli, Gian Luca Erre, Matteo Piga, Garifallia Sakellariou, Andreina Manfredi, Marco Fornaro, Ombretta Viapiana, Simone Perniola, Elisa Gremese, Fabiola Atzeni, and Elena Bartoloni.
• Rheumatology Unit, Department of Precision and Regenerative Medicine and Ionian Area (DePReMeI), Università degli Studi di Bari, Italy; Department of Medicine and Surgery, LUM University, Casamassima, Bari, Italy.
• Eur. J. Intern. Med. 2024 Nov 5.

Background/AimLipid-lowering therapy prescription is low in rheumatoid arthritis (RA) patients, often not achieving lipid threshold target despite treatment. However, evidence derives from small, monocentric cohorts. We assessed adherence to lipid-lowering treatment for primary cardiovascular (CV) prevention in a RA cohort according to international guidelines.MethodsA cross-sectional analysis of an Italian RA cohort was performed. Disease-related features and traditional CV risk factors were collected. The 10-year CV risk was estimated by Systematic COronary Risk Evaluation 2 (SCORE-2) algorithm. The primary preventive dyslipidaemia strategy was assessed according to 2019 European Society of Cardiology/European Atherosclerosis Society guidelines.Results1.133 RA patients (78.2% female, aged 60.6±10.2 years) free from CV events were included. According to SCORE-2, 42.9% of patients were at moderate risk (1-5-%), 33.3% at high risk (5-10%) and 23.7% at very high risk (>10%). In the whole cohort, 12.9% of patients with <5%, 23.6% with 5-10% and 32.3% with >10% risk were on statin, respectively (p<0.001). According to 2019 ESC/EAS guidelines, 51.5% of patients had LDL-c at target. Among patients with LDL-c not at target, 76% were not on lipid-lowering treatment. At multivariate analysis, patients with higher CV risk had significantly lower probability of LDL-c at target.ConclusionIn a wide Italian RA cohort, more than 50% of patients had high or very high CV risk. In these, lipid-lowering treatment prescription is suboptimal leading to not achievement of LDL-c target. Physicians should improve lipid screening and primary prevention therapy to reduce CV risk and improve CV comorbidity in RA patients.Copyright © 2024. Published by Elsevier B.V.

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