Article open access publication

EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update

Annals of the Rheumatic Diseases, BMJ, ISSN 0003-4967

Volume 76, 1, 2017

DOI:10.1136/annrheumdis-2016-209775, Dimensions: pub.1040911538, PMID: 27697765,



  1. (1) VU University Medical Center, grid.16872.3a
  2. (2) Diakonhjemmet Hospital, grid.413684.c
  3. (3) University of Glasgow, grid.8756.c
  4. (4) Paris Descartes University, grid.10992.33
  5. (5) Medical University of Vienna, grid.22937.3d
  6. (6) Istituto Ortopedico Galeazzi, grid.417776.4
  7. (7) Hospital of Southern Jutland, grid.416811.b, Southern Denmark Region
  8. (8) King Christian 10's Hospital for Rheumatic Diseases, Graasten, Denmark.
  9. (9) University of Southern Denmark, grid.10825.3e, SDU
  10. (10) Umeå University, grid.12650.30
  11. (11) PARE (patient research partners), Sint-Joris-Weert, Belgium.
  12. (12) 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.
  13. (13) Oslo University Hospital, Ullevål, Center for Preventive Medicine and Medical Faculty, University of Oslo, Oslo, Norway.
  14. (14) Lund University, grid.4514.4
  15. (15) University of Gothenburg, grid.8761.8
  16. (16) Universitair Ziekenhuis Leuven, grid.410569.f
  17. (17) University of Cantabria, grid.7821.c
  18. (18) Russells Hall Hospital, grid.416281.8
  19. (19) University of Debrecen, grid.7122.6
  20. (20) University of Manchester, grid.5379.8


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.


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