Background A comorbid condition is a medical condition that is present in addition to rheumatoid arthritis (RA). Physicians and researchers are interested in comorbidity because of its effect on life quality, RA prognosis and the outcome . RA can damage a joint with secondary osteoarthritis (OA)manifestation.
Objectives The study is focused on estimating the risk factors of developing secondary osteoarthritis of the knee in patients with rheumatoid arthritis.
Methods The analytical study of risk factors of secondary OA of the knee was conducted with 260 patients. RA was diagnosed according to the criteria of EULAR/ACR, the average age of patients was 52,1±11,3, 84,3% of them were females, the disease lasted from 3 to 15 years. To reveal the risk factors of developing secondary OA of the knee in RA, patients were divided into two groups: group 1 included 120 patients with secondary OA in RA, group 2 was comprised of 140 patients with RA. To diagnose coexisting secondary OA of the knee we used clinical investigation, US and X-ray.
Results The results of logistic regression are presented in rating. It demonstrates the significant modified and unmodified risk factors of RA patients associated with secondary OA. Long-term therapy of glucocorticoids and high activity on DAS 28 increase the risk of development of secondary OA of the knee in patients with RA by 5 and 3,5 times respectively (5,05-2,52120 min and pain on VAS>50 mm in group 1; 25% and 41% of patients from group 2 had the same symptoms. According to the results of the trial, the risk of developing secondary osteoarthritis increases when unmodified factors are present. Those are age >45 years and the duration of the disease >10 years.
Conclusions The significant risk factors of secondary OA of the knee (in addition with unmodified factors) associate with the consequences of chronic inflammation in RA. Long-term therapy of glucocorticoids, high activity of the disease on DAS28, morning stiffness >120 min and pain on VAS>50 min in combination with unmodified parameters increase the risk of developing secondary OA of the knee in patients with RA.
Michaud K., Wolfe F. Comorbidities in rheumatoid arthritis. Best Practice & Research Clinical Rheumatology, 2007;21(5):885–906.
Disclosure of Interest None declared
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