Prevalence of Thyroid Dysfunction in Newly Diagnosed Rheumatoid Arthritis Patients

Nazary, Kefayatullah; Hussain, Nabeel; Ojo, Roland Oluwapelumi; Anwar, Sana; Kadurei, Firas; Hafizyar, Farukhzad; Haroon, Daniya Muhammad; Khemani, Rakesh; Talpur, Abdul Subhan

doi:10.7759/cureus.18204

Cited by 6 publications

(12 citation statements)

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“…made the final decision. Finally, 29 studies ( 5 , 11 , 13 , 14 , 22 – 46 ) that met all inclusion criteria were absorbed in the meta-analysis. Figure 1 shows the detailed screening steps.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-nine studies met the inclusion criteria, involving 35,708 RA patients and 149,421 non-RA controls. Among them, 15 studies ( 5 , 11 , 13 , 22 , 24 , 25 , 27 , 31 , 33 , 34 ) provided ( 37 – 40 , 45 ) prevalence values for hyperthyroidism, 12 provided ( 5 , 11 , 22 , 24 , 31 , 33 , 34 , 36 , 37 , 42 , 44 , 45 ) prevalence values for subclinical hyperthyroidism, 26 provided ( 5 , 11 , 13 , 14 , 22 – 31 , 33 – 41 , 43 , 45 , 46 ) prevalence values for hypothyroidism, and 17 provided ( 5 , 11 , 14 , 22 , 24 , 31 – 34 , 36 – 39 , 42 – 45 ) prevalence values for subclinical hypothyroidism. The NOS checklist was used to evaluate the quality of studies, and 7 studies (24.13%) assessed as high quality, and 18 studies (62.07%) identified as medium quality.…”

Section: Resultsmentioning

confidence: 99%

“…Fifteen studies ( 5 , 11 , 13 , 22 , 24 , 25 , 27 , 31 ) recorded the prevalence of hyperthyroidism in RA and control groups ( 33 , 34 , 37 – 40 , 45 ). However, in 5 literatures ( 27 , 31 , 33 , 34 , 45 ), there is no information on hyperthyroidism in RA patients or controls.…”

Section: Resultsmentioning

confidence: 99%

“…After excluding two studies ( 31 , 44 ), in which subclinical hyperthyroidism was not found in any subjects, the prevalence of subclinical hyperthyroidism in RA patients and controls was calculated in a total of 10 studies ( 5 , 11 , 22 , 24 , 33 , 34 , 36 , 37 , 42 , 45 ) ( Figure 2B ). The pooled OR was 2.13 (95%CI 1.25–3.63) (P < 0.05), indicating that RA patients had more than twice the risk of subclinical hyperthyroidism as non-RA subjects, which was statistically significant.…”

Section: Resultsmentioning

confidence: 99%

“…Recently, a meta-analysis ( 4 ) determined that the global prevalence of RA was approximately 0.46% over the past 40 years. Moreover, RA has been found to be potentially associated with a variety of autoimmune diseases, including thyroid dysfunction ( 5 ). Thyroid dysfunction mainly includes hyperthyroidism, hypothyroidism, subclinical hyperthyroidism and subclinical hypothyroidism.…”

Section: Introductionmentioning

confidence: 99%

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Association between rheumatoid arthritis and thyroid dysfunction: A meta-analysis and systematic review

et al. 2022

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ObjectiveRheumatoid arthritis (RA) is an autoimmune disorder. Multiple studies have investigated the risk of thyroid dysfunction in patients with RA but have reached conflicting conclusions. This systematic review aimed to determine whether patients with RA are at higher risk of thyroid dysfunction.MethodsWe comprehensively reviewed online literature databases, including PubMed, Scopus, Embase, and the Cochrane Library, from their respective inception dates to March 25, 2022. Studies that provided data on at least one case of thyroid dysfunction in RA patients and their controls were included. Based on these data, we calculated pooled odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) for thyroid dysfunction in RA and non-RA patients.ResultsTwenty-nine studies met the inclusion criteria, involving a total of 35,708 patients with RA. The meta-analysis showed that, compared with non-RA patients, RA patients had an increased risk of developing thyroid dysfunction, particularly hypothyroidism (OR 2.25, 95% CI 1.78–2.84). Subgroup analysis suggested that study type and sample source of control group were the source of heterogeneity.ConclusionsPatients with RA are at increased risk of developing thyroid dysfunction, especially hypothyroidism. Routine biochemical examination of thyroid function in RA patients should be strengthened. Larger prospective studies are needed to explore the causal relationship between RA and thyroid dysfunction, and to investigate the impact of thyroid dysfunction on RA disease activity, drug efficacy, and medication safety.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022331142.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association between rheumatoid arthritis and thyroid dysfunction: A meta-analysis and systematic review

et al. 2022

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The association between thyroid dysfunction, autoimmune thyroid disease, and rheumatoid arthritis disease severity

Yazdanifar,

Bagherzadeh-Fard,

Habibi

et al. 2023

BMC Endocr Disord

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Background Rheumatoid Arthritis (RA) and autoimmune thyroid disease (AITD) are the two most prevalent coexisting autoimmune diseases due to their similar pathogenesis. Considering the potential effect of AITD on the severity of RA disease, this study aimed to determine the association between thyroid dysfunction, anti-thyroid peroxidase (anti-TPO) positivity, AITD, and RA disease severity in the Iranian population. Methods Three hundred and fifty RA patients who presented to Shahid Beheshti tertiary care center, Qom, Iran, were included in this cross-sectional study. The data were collected through the patient’s medical records, interviews, physical examinations, and laboratory tests. The RA disease activity score in 28 joints for RA with erythrocyte sedimentation rate (DAS-28-ESR) was used to divide patients into three subgroups, remission (DAS-28-ESR ⩽ 2.6), mild-to-moderate (2.6 < DAS-28-ESR ⩽ 5.1), and severe disease activity (DAS-28-ESR > 5.1). Results Using the aforementioned method, 111, 96, and 138 patients were put into remission, mild-to-moderate, and severe disease activity groups, respectively. Anti-TPO antibody positivity rate was 2.93 times more prevalent among patients with severe disease compared to the remission subgroup (OR: 2.93; P-value < 0.001). Patients suffering from a more severe disease were almost 2.7 times more probable to have AITD (OR = 2.71; P-value < 0.001) and they were 82% more likely to have thyroid dysfunction compared to patients in remission (OR = 1.82; P-value = 0.006). Conclusions It was demonstrated that thyroid dysfunction, anti-TPO antibody positivity, and AITD were significantly more common among RA patients with more severe disease activity.

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Prevalence of hypothyroidism in rheumatoid arthritis and its correlation with disease activity

jeha

2022

Preprint

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Background: Several recent studies have shown an increased incidence of hypothyroidism in many chronic inflammatory diseases, especially rheumatoid arthritis, and others studies have shown a relationship between hypothyroidism in patients with rheumatoid disease and the degree of disease activity. Aim of the study: To know the extent of hypothyroidism in a sample of patients with rheumatoid arthritis in Al-Assad and Al-Mowasat University Hospital in Damascus, to link this to the effectiveness of rheumatoid disease, and to compare with a group of healthy controls. Materials and methods: a cross-sectional/case-control study was conducted on 134 patients diagnosed with rheumatoid arthritis, and a healthy cohort of 134 people from the University Hospitals in Damascus. The presence of hypothyroidism was compared between the two groups of patients and controls. Hypothyroidism in patients was also compared with the disease activity index, after dividing them according to the effectiveness index (DAS28-ESR) into three groups: mild, moderate, and severe disease activity. The data was analyzed using the statistical analysis program (SPSS) version (25) and the variable was considered statistically significant when the P-Value is less than (0.05). Results: The average age of both patients and controls was (50.6±3.9) and (44.3±2.01) years, respectively. The proportion of females in the sample of patients was (%84.3) and the percentage of females in the control sample (%80.6), the number of patients with hypothyroidism was 43 patients (%32), and the number of infected controls was 10 people (%7.5) P-Value < 0.000. The type of hypothyroidism in patients was classified into clinical hypothyroidism (%67.44) and subclinical hypothyroidism (%32.56). %24.6 of patients and %6 of controls had positive TPO antibodies (P-Value < 0.000). The study has shown a positive correlation between hypothyroidism and disease efficacy indicator (DAS28-ESR). Conclusion: Increased incidence of hypothyroidism and TPO antibodies in patients with rheumatoid disease compared to healthy subjects, and an increase in the degree of disease activity in patients with rheumatoid disease diagnosed with hypothyroidism compared to patients with rheumatoid disease without hypothyroidism.

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Prevalence of Thyroid Dysfunction in Newly Diagnosed Rheumatoid Arthritis Patients

Abstract: Introduction: Rheumatoid arthritis (RA) is associated with various autoimmune disorders, including thyroid dysfunction. However, local data studying the prevalence of thyroid dysfunction in newly diagnosed RA patients are limited.

Cited by 6 publications

References 13 publications

Association between rheumatoid arthritis and thyroid dysfunction: A meta-analysis and systematic review

Association between rheumatoid arthritis and thyroid dysfunction: A meta-analysis and systematic review

The association between thyroid dysfunction, autoimmune thyroid disease, and rheumatoid arthritis disease severity

Prevalence of hypothyroidism in rheumatoid arthritis and its correlation with disease activity

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