TY - JOUR
T1 - Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring
T2 - results of an international, cross-sectional study (COMORA)
AU - Dougados, Maxime
AU - Soubrier, Martin
AU - Antunez, Anna
AU - Balint, Peter
AU - Balsa, Alejandro
AU - Buch, Maya H
AU - Casado, Gustavo
AU - Detert, Jacqueline
AU - El-Zorkany, Bassel
AU - Emery, Paul
AU - Hajjaj-Hassouni, Najia
AU - Harigai, Masayoshi
AU - Luo, Shue-Fen
AU - Kurucz, Reka
AU - Maciel, Gabriel
AU - Mola, Emilio Martin
AU - Montecucco, Carlo Maurizio
AU - McInnes, Iain
AU - Radner, Helga
AU - Smolen, Josef S
AU - Song, Yeong-Wook
AU - Vonkeman, Harald Erwin
AU - Winthrop, Kevin
AU - Kay, Jonathan
PY - 2014/1
Y1 - 2014/1
N2 - BACKGROUND: PATIENTS with rheumatoid arthritis (RA) are at increased risk of developing comorbid conditions.OBJECTIVES: To evaluate the prevalence of comorbidities and compare their management in RA patients from different countries worldwide.METHODS: STUDY DESIGN: international, cross-sectional.PATIENTS: consecutive RA patients.DATA COLLECTED: demographics, disease characteristics (activity, severity, treatment), comorbidities (cardiovascular, infections, cancer, gastrointestinal, pulmonary, osteoporosis and psychiatric disorders).RESULTS: Of 4586 patients recruited in 17 participating countries, 3920 were analysed (age, 56±13 years; disease duration, 10±9 years (mean±SD); female gender, 82%; DAS28 (Disease Activity Score using 28 joints)-erythrocyte sedimentation rate, 3.7±1.6 (mean±SD); Health Assessment Questionnaire, 1.0±0.7 (mean±SD); past or current methotrexate use, 89%; past or current use of biological agents, 39%. The most frequently associated diseases (past or current) were: depression, 15%; asthma, 6.6%; cardiovascular events (myocardial infarction, stroke), 6%; solid malignancies (excluding basal cell carcinoma), 4.5%; chronic obstructive pulmonary disease, 3.5%. High intercountry variability was observed for both the prevalence of comorbidities and the proportion of subjects complying with recommendations for preventing and managing comorbidities. The systematic evaluation of comorbidities in this study detected abnormalities in vital signs, such as elevated blood pressure in 11.2%, and identified conditions that manifest as laboratory test abnormalities, such as hyperglycaemia in 3.3% and hyperlipidaemia in 8.3%.CONCLUSIONS: Among RA patients, there is a high prevalence of comorbidities and their risk factors. In this multinational sample, variability among countries was wide, not only in prevalence but also in compliance with recommendations for preventing and managing these comorbidities. Systematic measurement of vital signs and laboratory testing detects otherwise unrecognised comorbid conditions.
AB - BACKGROUND: PATIENTS with rheumatoid arthritis (RA) are at increased risk of developing comorbid conditions.OBJECTIVES: To evaluate the prevalence of comorbidities and compare their management in RA patients from different countries worldwide.METHODS: STUDY DESIGN: international, cross-sectional.PATIENTS: consecutive RA patients.DATA COLLECTED: demographics, disease characteristics (activity, severity, treatment), comorbidities (cardiovascular, infections, cancer, gastrointestinal, pulmonary, osteoporosis and psychiatric disorders).RESULTS: Of 4586 patients recruited in 17 participating countries, 3920 were analysed (age, 56±13 years; disease duration, 10±9 years (mean±SD); female gender, 82%; DAS28 (Disease Activity Score using 28 joints)-erythrocyte sedimentation rate, 3.7±1.6 (mean±SD); Health Assessment Questionnaire, 1.0±0.7 (mean±SD); past or current methotrexate use, 89%; past or current use of biological agents, 39%. The most frequently associated diseases (past or current) were: depression, 15%; asthma, 6.6%; cardiovascular events (myocardial infarction, stroke), 6%; solid malignancies (excluding basal cell carcinoma), 4.5%; chronic obstructive pulmonary disease, 3.5%. High intercountry variability was observed for both the prevalence of comorbidities and the proportion of subjects complying with recommendations for preventing and managing comorbidities. The systematic evaluation of comorbidities in this study detected abnormalities in vital signs, such as elevated blood pressure in 11.2%, and identified conditions that manifest as laboratory test abnormalities, such as hyperglycaemia in 3.3% and hyperlipidaemia in 8.3%.CONCLUSIONS: Among RA patients, there is a high prevalence of comorbidities and their risk factors. In this multinational sample, variability among countries was wide, not only in prevalence but also in compliance with recommendations for preventing and managing these comorbidities. Systematic measurement of vital signs and laboratory testing detects otherwise unrecognised comorbid conditions.
KW - Adult
KW - Aged
KW - Arthritis, Rheumatoid/epidemiology
KW - Cardiovascular Diseases/epidemiology
KW - Comorbidity
KW - Cross-Sectional Studies
KW - Female
KW - Gastrointestinal Diseases/epidemiology
KW - Global Health
KW - Humans
KW - Infection/epidemiology
KW - Internationality
KW - Lung Diseases/epidemiology
KW - Male
KW - Mental Disorders/epidemiology
KW - Middle Aged
KW - Neoplasms/epidemiology
KW - Osteoporosis/epidemiology
KW - Prevalence
KW - Risk Factors
KW - Severity of Illness Index
U2 - 10.1136/annrheumdis-2013-204223
DO - 10.1136/annrheumdis-2013-204223
M3 - Article
C2 - 24095940
SN - 0003-4967
VL - 73
SP - 62
EP - 68
JO - Annals of the rheumatic diseases
JF - Annals of the rheumatic diseases
IS - 1
ER -
