Ab0314 multimorbidity Burden in Rheumatoid Arthritis

Abstract

BackgroundMultimorbidity in patients with rheumatoid arthritis (RA) has been described as the coexistence of two or more chronic diseases and is the most common cause of death in this population.ObjectivesTo describe the prevalence of multimorbidity and mortality trends in a well-characterized cohort of patients with RA.MethodsA retrospective cohort study of patients with RA (1987 ACR criteria) was conducted. Each patient was evaluated and followed by a rheumatologist in a single outpatient private center in Bogotá, Colombia, from 2014 to 2021. Categorical variables were expressed in frequency and percentage and quantitative variables in mean and standard deviation or median with interquartile range, depending on the distribution of the data. Statistical package: SPSS 25.ResultsA total of 783 patients were included. 11% of patients with RA present multimorbidity. Baseline characteristics were as follows: female gender 81.6%, mean age 51.8±11 years, mean disease duration 8 (IQR 3-15) years, RF positive 80.1%, ACPA positive 58.2%, and erosions 24.9%. Most patients have received glucocorticoids (89.8%), and conventional synthetic DMARDs (97.8%), being prednisone and methotrexate the most frequently prescribed. Hypertension was prevalent in 27.7%, osteoporosis 19.3%, malignancies in 5.5% and principal infection was urinary infection 14.3%. Polyautoimmunity was present in 5.7% most frequently Autoimmune thyroid diseases 10.6% and Sjögren syndrome 9%. After a median of 73 months of follow-up, the mortality rate was 1% of the entire cohort, being cardiovascular disease and COVID-19 infection the main causes.ConclusionPatients with RA have an important multimorbidity burden and this increased risk of adverse outcomes and mortality.References[1]Figus FA, Piga M, Azzolin I, McConnell R, Iagnocco A. Rheumatoid arthritis: Extra-articular manifestations and comorbidities. Autoimmun Rev. 2021 Apr;20(4):102776. doi: 10.1016/j.autrev.2021.102776.[2]McQueenie R, Nicholl BI, Jani BD, Canning J, Macdonald S, McCowan C, Neary J, Browne S, Mair FS, Siebert S. Patterns of multimorbidity and their effects on adverse outcomes in rheumatoid arthritis: a study of 5658 UK Biobank participants. BMJ Open. 2020 Nov 23;10(11):e038829. doi: 10.1136/bmjopen-2020-038829Table 1.Prevalence of the diseases.DiseasePrevalenceChronic diseaseHypertension27.7%Dyslipidemia26.7%Osteoporosis19.3%Obesity7.7%Diabetes Mellitus7%Cardiovascular diseaseMyocardial infarction3.4%Cerebrovascular disease1.4%Thrombosis1.8%InfectionsUrinary infection14.3%Tuberculosis11.2%COVID-198.2%Autoimmune diseaseAutoimmune thyroid diseases10.6%Sjögren syndrome9%Systemic Lupus Erythematosus2%Disclosure of InterestsNone declared

Comorbidities and extra-articular manifestations of Rheumatoid arthritis in sub-Saharian Africa

“…Bentaleb et al [30] reported a prevalence of depression that varied between 2 to 62.11% and that of cancer at 2%. The frequency of dyslipidemia in patients was observed in the study by Varela et al [34] and Santos-Moreno et al [35] with respectively a prevalence of 26.7% and 45%. Harold et al [33] reported an asthma prevalence of 2.1%.…”

“…The infection was reported by Harrold et al [33] and Varela et al [34] respectively 5.1% and 14.6%. The occurrence of infections in this population may also be favored by immunosuppressants frequently used in the treatment of polyarthritis; they are often pulmonary and urinary [34,40,44].…”

“…The mean hemoglobin level was low (11.6 g/dl) according to Gheita et al [29] and the prevalence of anemia varying between 28.8 and 23% according to Bentaleb et al [30]. The infection was reported by Harrold et al [33] and Varela et al [34] respectively 5.1% and 14.6%. The occurrence of infections in this population may also be favored by immunosuppressants frequently used in the treatment of polyarthritis; they are often pulmonary and urinary [34,40,44].…”