Background Patients with rheumatoid arthritis (RA) have an increased risk of developing comorbid conditions which are associated to increased mortality, hospital admissions, higher costs of care and inability to work (1, 2).
Objectives To evaluate the prevalence of comorbidities in a Mexican mestizo population of RA patients.
Methods We performed a cross-sectional study in which RA patients who were admitted to our outpatient clinic between August 2014 and December 2016 were consecutively enrolled. We collected data regarding demographics, disease characteristics (activity, severity, treatment), comorbidities (cardiovascular, infections, cancer, and osteoporosis), and performed blood tests at the time of the patient's visit to the clinic.
Results We analyzed 225 patients. Their characteristics are shown in Table 1. Age, 55.7±8.3 years (mean ± SD); disease duration, 9.5 (4 – 15.5) (median (IQR)); female gender, 93.7%; Disease Activity Score using 28 joints–C-reactive protein (DAS28-CRP), 3 (2 – 4) (median (IQR)); past or current methotrexate use, 84.9%; past or current use of any other conventional disease modifying anti-rheumatic drug (cDMARD), 52.4%; past or current use of biological agents, 8%. The most frequently associated diseases were: hypertension, 29.8%; dyslipidemia, 27.1%; osteoporosis, 19.1%; diabetes, 12.4%; hypothyroidism, 6.2%; solid malignancies (excluding basal cell carcinoma), 4.4%. Risk factors were also evaluated, the most prevalent was overweight (BMI ≥25 <30) present in 101 (44.9%) of our patients. A total of 71 (31.6%) had obesity (BMI ≥30). The systematic evaluation of our patients allowed us to detect abnormalities in vital signs, such as elevated blood pressure in 12.4%, and to identify conditions that manifest as laboratory test abnormalities, such as hyperglycemia in 27.1% and hyperlipidemia in 49.8%.
Conclusions This study confirms the high prevalence of comorbidities in RA patients. Among our cohort, 63.5% had at least one comorbidity, being those associated with cardiovascular disease the most common. With a systematic assessment (3) including a thorough physical examination, vital signs and laboratory tests, it is possible to detect comorbid conditions that would otherwise remain unrecognized.
Dougados M, Soubrier M, Antunez A, Balint P, Balsa A, Buch MH, et al. Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA). Ann Rheum Dis. 2014;73(1):62–8.
Gabriel SE, Michaud K. Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases. Arthritis Res Ther. 2009;11(3):229.
Baillet A, Gossec L, Carmona L, Wit M, van Eijk-Hustings Y, Bertheussen H, et al. Points to consider for reporting, screening for and preventing selected comorbidities in chronic inflammatory rheumatic diseases in daily practice: a EULAR initiative. Ann Rheum Dis. 2016;75(6):965–73.
Disclosure of Interest None declared