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Points to consider for reporting, screening for and preventing selected comorbidities in chronic inflammatory rheumatic diseases in daily practice: a EULAR initiative
  1. Athan Baillet1,
  2. Laure Gossec2,
  3. Loreto Carmona3,
  4. Maarten de Wit4,
  5. Yvonne van Eijk-Hustings5,
  6. Heidi Bertheussen4,
  7. Kent Alison6,
  8. Mette Toft4,
  9. Marios Kouloumas7,
  10. Ricardo J O Ferreira8,
  11. Susan Oliver9,
  12. Andrea Rubbert-Roth10,
  13. Sander van Assen11,
  14. William G Dixon12,
  15. Axel Finckh13,
  16. Angela Zink14,
  17. Joel Kremer15,
  18. Tore K Kvien16,
  19. Michael Nurmohamed17,
  20. Desirée van der Heijde18,
  21. Maxime Dougados19
  1. 1Department of Rheumatology, Université Joseph Fourier, GREPI—CNRS, Grenoble Hospital, France
  2. 2Department of Rheumatology, Sorbonne Universités, UPMC Univ Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique, GRC-UPMC 08 (EEMOIS); AP-HP, Pitié Salpêtrière Hospital, Paris, France
  3. 3Instituto de Salud Musculoesquelética, Madrid, Spain
  4. 4EULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland
  5. 5Integrated Care, Maastricht University Medical Centre, Maastricht, The Netherlands
  6. 6Salisbury NHS Foundation Trust Hospital, Salisbury, UK
  7. 7Cyprus League Against Rheumatism, Cyprus, Nikosia, Cyprus
  8. 8Department of Rheumatology, Centro Hospitalar e Universitário de Coimbra; Health Sciences Research Unit: Nursing (UICiSA:E), Coimbra, Portugal
  9. 9Independent Nurse Consultant, North Devon, UK
  10. 10Department of Internal Medicine, University of Cologne, Cologne, Germany
  11. 11Department of Internal Medicine, Division of Infectious Diseases, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
  12. 12Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
  13. 13Division of Rheumatology, Geneva University Hospital, Geneva, Switzerland
  14. 14Epidemiology Unit, German Rheumatism Research Centre, and Rheumatology, Charité, University Medicine, Berlin, Germany
  15. 15Albany Medical College and The Center for Rheumatology, Albany, USA
  16. 16Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
  17. 17Amsterdam Rheumatology immunology Center | VUmc and Reade, The Netherlands
  18. 18Department of Rheumatology, Leiden University Medical Center, The Netherlands
  19. 19Department of Rheumatology, Paris Descartes University—Hôpital Cochin. Assistance Publique—Hôpitaux de Paris. INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité, Paris, France
  1. Correspondence to Dr Athan Baillet, Service de Rhumatologie CHU Grenoble, Av de Kimberley, Echirolles 38434, France; abaillet{at}


In chronic inflammatory rheumatic diseases, comorbidities such as cardiovascular diseases and infections are suboptimally prevented, screened for and managed. The objective of this European League Against Rheumatism (EULAR) initiative was to propose points to consider to collect comorbidities in patients with chronic inflammatory rheumatic diseases. We also aimed to develop a pragmatic reporting form to foster the implementation of the points to consider. In accordance with the EULAR Standardised Operating Procedures, the process comprised (1) a systematic literature review of existing recommendations on reporting, screening for or preventing six selected comorbidities: ischaemic cardiovascular diseases, malignancies, infections, gastrointestinal diseases, osteoporosis and depression and (2) a consensus process involving 21 experts (ie, rheumatologists, patients, health professionals). Recommendations on how to treat the comorbidities were not included in the document as they vary across countries. The literature review retrieved 42 articles, most of which were recommendations for reporting or screening for comorbidities in the general population. The consensus process led to three overarching principles and 15 points to consider, related to the six comorbidities, with three sections: (1) reporting (ie, occurrence of the comorbidity and current treatments); (2) screening for disease (eg, mammography) or for risk factors (eg, smoking) and (3) prevention (eg, vaccination). A reporting form (93 questions) corresponding to a practical application of the points to consider was developed. Using an evidence-based approach followed by expert consensus, this EULAR initiative aims to improve the reporting and prevention of comorbidities in chronic inflammatory rheumatic diseases. Next steps include dissemination and implementation.

  • Autoimmune Diseases
  • Cardiovascular Disease
  • Infections
  • Multidisciplinary team-care
  • Osteoporosis

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