Background Rheumatoid artritis (RA) is a chronic and autoimmune disorder that primarily affects middle and older ages. Comorbidities are important during RA treatment.
Objectives We aim to determine the frequency of comorbidites and surgical history in the RA patients who receive biological agents.
Methods Hacettepe University Biologic Registry (HUR-BIO) includes demographic and clinical data of patients treated with biological agent since 2005. By August 2016, 1235 RA patients were recorded in the database. Age, gender, smoking habits, disease duration, rheumatoid factor, anti citrullinated peptide (CCP), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), current and previous treatments, comorbidites and surgical history of patients were analyzed. Comorbidites and surgery history were determined by patients medical records. Disease activity was estimated by the 28-joint activity calculator- C reactive protein (DAS28-CRP). Functional assessment was evaluated by the Health Assessment Questionnaire (HAQ).
Results Mean age (SD) of the patients (79,8% women) was 53,1 (12,6) and the mean disease duration was 11,0 (7,7) years. Of patients, 166 (16,6%) were older than 65 years. A total of 630 (63%) patients education level were less than high school, 197 (19,7%) of the patients were graduated from university. Smoking habitus of patients was as follows, 599 (59,9%) never smoked, 189 (18,9%) current smoker and 212 (21,2%) ex-smoker. At least one cardiovascular risk factor was detected in 699 (69,9%) patients. Comorbidities and surgical history of patients were shown in the table below. Patients with at least one comorbidity had less frequently female (77.3% vs 84.5%, p=0.007), high seropositivitly of RF (66% vs 57.1%, p=0.004), high patient global assessment (4.4±2.5 vs 3.9±3.9, p=0.007), high fatique score (4.6±3 vs 3.9±3.1, p=0.001), high pain score (4.8±2.5 vs 4.0±2.8, p=0.009), DAS-28 (3.43±1.39 vs 3.17±1.48, p=0,009) and high HAQ score (0.72±0.59 vs 0.58±0.54, p=0.001) than patients without comorbidities.
Conclusions Comorbidities and past surgical history should be considered in RA patients when biological therapy is indicated. Comorbidities is one of the important conditions for physicians to manage patients. Cardiovascular, chronic viral infection such as hepatitis B and C, tuberculosis and cancer have to be investigated to start biological treatments. Surgical history such as cataracts, ortopedic surgery were also important for clinicians. HURBIO data demonstrated that patients with at least one comorbidities reflects more negative patient outcome measures.
Disclosure of Interest None declared