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  1. C. Flourou1,
  2. S. Psarelis2,
  3. A. Tofarides3,
  4. E. Papanicolaou4,
  5. G. Papazisis5
  1. 1Nicosia General Hospital, Internal Medicine Department, Nicosia, Cyprus
  2. 2Nicosia General Hospital, Rheumatology Department, Nicosia, Cyprus
  3. 3Nicosia General Hospital, Internal Medicine Department, Nicosia, Cyprus
  4. 1Nicosia General Hospital, Internal Medicine Department, Nicosia, Cyprus
  5. 5Aristotle University of Thessaloniki, Clinical Pharmacology, Thessaloniki, Greece


Background: Charlson Comorbidity Index[1] is a tool including age and chronic diseases assessing the comorbidity burden. The age and the comorbidity burden in RA patients determine the morbidity and mortality.

Objectives: To assess and classification of CCI in RA patients with usage of the health-care system (outpatient clinics) in a real-world setting.

Methods: 327 patients with RA from a large outpatient service of a central hospital were retrospectively reviewed. Demographic characteristics, treatment for RA and comorbidities were recorded. Charlson Comorbidity Index (CCI) was measured and classified as low, intermediate and high score for 1-2, 3-4 and >=5 points, respectively. Its correlation with polypharmacy and necessity of biologic DMARDs was studied. Univariable and multivariable analyses were performed.

Results: Data from 327 RA patients (75,8% females, 24,2%males) with a mean±SD age of 63±11,8 years and disease duration 113±63 months, were recorded.

CCI was 3±1,2 points (mean±SD) and maximum score was observed at 7 points. High score (>=5points) was observed at 9,2% and in the majority the score was intermediate (3-4points) at 55%. All the RA patients with high score fulfilled the criteria of polypharmacy. Patients with high score had 9,7 times more probability of polypharmacy than the patients with low score (p=0.09, 1.4-2.5 95%CI).

70 patients were treated with biologic-DMARDs (21,7%), in the majority with TNFa inhibitors (16,5%). In RA patients receiving biologic-DMARDs was observed low or intermediate score of CCI. Τhe most likely explanation is the severity of the disease that predominated, its complications and the possible overlap with other conditions.

Conclusion: The majority of RA patients had intermediate score of CCI. In patients with high score-meaning more comorbidities- polypharmacy was observed completely. Patients receiving biologic-DMARDs characterized with less comorbidities.

References: [1]Charlson E M et al. A new method of classifying prognostic comorbidity in longitudinal studies:development and validation. J Chronic Dis. 1987;40(5):373-83.

Disclosure of Interests: None declared

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