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FRI0088 Prevalence of Comorbidities in Patients with Rheumatoid Arthritis Using Japanese Health Insurance Database
  1. R. Sakai1,2,
  2. F. Hirano1,2,
  3. M. Kihara1,2,
  4. W. Yokoyama1,2,
  5. H. Yamazaki1,2,
  6. R. Koike1,2,3,
  7. N. Miyasaka4,5,
  8. M. Harigai1,2
  1. 1Department of Pharmacovigilance
  2. 2Department of Rheumatology
  3. 3Clinical Research Center
  4. 4Global Center of Excellence Program; International Research Center for Molecular Science in Tooth and Bone Diseases
  5. 5Tokyo Medical and Dental University, Tokyo, Japan

Abstract

Background The high prevalence or risk of comorbidities in patients with rheumatoid arthritis (RA) has been reported1,2. It is essential for rheumatologists to manage comorbidities appropriately since they influence on prognosis of RA patients3. However, there are no reports investigating the prevalence of comorbidities such as cardiovascular diseases in RA patients using large population-based data in Asia.

Objectives To compare the prevalence of comorbidities between RA cases and non-RA cases and reveal the association between RA and comorbidities using Japanese health insurance database.

Methods This cross-sectional, population-based study was conducted using reimbursement data provided by the Japan Medical Data Center Co., Ltd. We defined individuals as RA cases if they had at least two physician visits more than two months apart with RA diagnostic codes4 (ICD10 codes; M05, M060, M062, M063, M068, and M069) between June 2011 and May 2012 (RA group, n=2,762). The month that a patient had one of the RA diagnostic codes for the first time was defined as the index month. Among individuals who did not meet above criteria, we selected age- (±5 years), gender-, and observation term-matched non-RA cases at 1:10 ratio (RA cases: non-RA cases) (non-RA group, n=27,620). Patients who had the following ICD 10 codes (ischemic heart diseases (IHD) [I20-22, I25], cerebral infarction [I63], osteoporosis [M80-81]) and were prescribed for the comorbidities at least one time within 6 months before or after the index month were deemed as having comorbidities. We compared the prevalence of comorbidities between the two groups by chi-square test and investigated the association between RA and comorbidities using logistic regression analysis.

Results The mean age of this population was 50.4 for the RA group and 50.0 for the non-RA group, and 74.1% were female in the both groups. In the RA group, 9.4% of cases were prescribed biological DMARD, 29.1% methotrexate (MTX), 22.8% synthetic DMARDs other than MTX, and 31.6% oral corticosteroids in the index month. Prevalence of all the investigated comorbidities in the RA group was significantly higher compared to the non-RA group (RA vs. non-RA, IHD [5.0% vs. 1.4%], cerebral infarction [2.5% vs. 0.6%], osteoporosis [19.9% vs. 1.2%]). Odds ratios [95% confidence interval] of RA for IHD and cerebral infarction were 1.8 [1.5-2.3] and 2.0 [1.5-2.7], respectively, after adjusting for hypertension, hyperlipidemia, diabetes mellitus, and use of celecoxib, and for osteoporosis 9.4 [7.8-11.3] after adjusting for use of oral corticosteroids ≥5mg/day).

Conclusions This study revealed that RA was significantly associated with investigated comorbidities using health insurance database for the first time in Asia.

References

  1. Ann Rheum Dis 2013 DOI 10.1136/annrheumdis-2013-204223

  2. Curr Opin Rheumatol, 2013;25:317-324

  3. Arthritis Res Ther, 2009;11:229

  4. Arthritis Rheum, 2005;53:241-248

Acknowledgements This work was supported by the research grant from the Ministry of Health, Labour, and Welfare, Japan.

Disclosure of Interest R. Sakai Employee of: Tokyo Medical and Dental University (TMDU) receives unrestricted research grants from Abbvie Japan Co. Ltd., Astellas Pharma Inc., Bristol Meyears Squibb, Chugai Pharmaceutical Co. Ltd., Eisai Co. Ltd., Mitsubishi Tanabe Pharma Corp., Takeda Pharmaceutical Co. Ltd., and UCB Japan for Department of Pharmacovigilance with which TMDU pays salary for RS., F. Hirano: None declared, M. Kihara: None declared, W. Yokoyama: None declared, H. Yamazaki Employee of: Tokyo Medical and Dental University (TMDU) receives unrestricted research grants from Abbvie Japan Co. Ltd., Astellas Pharma Inc., Bristol Meyears Squibb, Chugai Pharmaceutical Co. Ltd., Eisai Co. Ltd., Mitsubishi Tanabe Pharma Corp., Takeda Pharmaceutical Co. Ltd., and UCB Japan for Department of Pharmacovigilance with which TMDU pays salary for HY., R. Koike: None declared, N. Miyasaka Grant/research support: NM has received research grants from Abbott Japan Co., Ltd., Astellas Pharma Inc., Bristol Myers Squibb, Chugai Pharmaceutical Co., Ltd., Dainihon-Sumitomo Pharma Co. Ltd., Daiichi-Sankyo Co. Ltd., Eisai Co. Ltd., Mitsubishi Tanabe Pharma Co., Novartis Pharma K.K., Ltd., Takeda Pharmaceutical Co., Ltd., Teijin Pharma Ltd and received Consulting fee or honorarium from Abbott Japan Co., Ltd., Bristol Myers Squibb, Janssen Pharmaceutical KK, and Otsuka Pharmaceutical Co. Ltd., M. Harigai Grant/research support: MH has also received research grants from Pfizer Japan Inc., Sanofi-Aventis KK., Santen Pharmaceutical Co., Ltd and Sekisui Medical Co., Ltd., Employee of: Tokyo Medical and Dental University (TMDU) receives unrestricted research grants from Abbvie Japan Co. Ltd., Astellas Pharma Inc., Bristol Meyears Squibb, Chugai Pharmaceutical Co. Ltd., Eisai Co. Ltd., Mitsubishi Tanabe Pharma Corp., Takeda Pharmaceutical Co. Ltd., and UCB Japan for Department of Pharmacovigilance with which TMDU pays salary for MH.

DOI 10.1136/annrheumdis-2014-eular.1296

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