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Abstract
Objectives:
Inflammatory arthritis (IA) is frequently associated with comorbidities but few studies have directly compared the prevalence of these comorbidities across IA. We aimed to compare thirty-nine comorbidities across rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA).
Materials and methods:
We analysed data from the UK Biobank, a cohort study of over 500,000 participants aged 40–69. IA and comorbidities were defined using ICD-10 codes, primary care codes, and/or self-reported diagnosis. Statistical analyses included ANOVA for continuous variables and Chi-squared tests for categorical variables. Logistic regression modelling was used to compare the odds of each comorbidity in IA against controls, adjusting for age, sex, body mass index, c-reactive protein and smoking.
Results:
A total of 230,055 participants were included (45.4% male; mean age 56.5), of which 1,969 had RA, 606 had PsA and 797 had axSpA. Hypertension (prevalence 9.0-11.1%) and dyspepsia (5.3-7.9%) were more prevalent in IA than controls. Individuals with RA had significantly higher odds of atherosclerotic cardiovascular diseases, including coronary artery disease (OR 2.1, 95% CI 1.66, 2.67), stroke/TIA (OR 1.78, 95% CI 1.09, 2.89), and peripheral vascular disease (OR 1.90, 95% CI 1.21, 2.99). Those with axSpA had higher odds of heart failure (OR 2.37, 95% CI 1.29, 4.34), atrial fibrillation (OR 1.59, 95% CI 1.03, 2.45) and epilepsy (OR 2.33, 95% CI 1.10, 4.94).
Conclusion:
IA is associated with a high prevalence of comorbidities, particularly cardiovascular, respiratory, and gastroenterological conditions. The prevalence and odds of developing atherosclerotic cardiovascular disease were highest in those with RA. Individuals with axSpA have increased odds of developing epilepsy, which is a novel finding. These findings underscore the heightened burden of comorbidities in individuals with IA and highlight differences in the specific comorbidities affecting each subtype.
Inflammatory arthritis (IA) is frequently associated with comorbidities but few studies have directly compared the prevalence of these comorbidities across IA. We aimed to compare thirty-nine comorbidities across rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA).
Materials and methods:
We analysed data from the UK Biobank, a cohort study of over 500,000 participants aged 40–69. IA and comorbidities were defined using ICD-10 codes, primary care codes, and/or self-reported diagnosis. Statistical analyses included ANOVA for continuous variables and Chi-squared tests for categorical variables. Logistic regression modelling was used to compare the odds of each comorbidity in IA against controls, adjusting for age, sex, body mass index, c-reactive protein and smoking.
Results:
A total of 230,055 participants were included (45.4% male; mean age 56.5), of which 1,969 had RA, 606 had PsA and 797 had axSpA. Hypertension (prevalence 9.0-11.1%) and dyspepsia (5.3-7.9%) were more prevalent in IA than controls. Individuals with RA had significantly higher odds of atherosclerotic cardiovascular diseases, including coronary artery disease (OR 2.1, 95% CI 1.66, 2.67), stroke/TIA (OR 1.78, 95% CI 1.09, 2.89), and peripheral vascular disease (OR 1.90, 95% CI 1.21, 2.99). Those with axSpA had higher odds of heart failure (OR 2.37, 95% CI 1.29, 4.34), atrial fibrillation (OR 1.59, 95% CI 1.03, 2.45) and epilepsy (OR 2.33, 95% CI 1.10, 4.94).
Conclusion:
IA is associated with a high prevalence of comorbidities, particularly cardiovascular, respiratory, and gastroenterological conditions. The prevalence and odds of developing atherosclerotic cardiovascular disease were highest in those with RA. Individuals with axSpA have increased odds of developing epilepsy, which is a novel finding. These findings underscore the heightened burden of comorbidities in individuals with IA and highlight differences in the specific comorbidities affecting each subtype.
| Original language | English |
|---|---|
| Journal | Archives of rheumatology |
| Publication status | Accepted/In press - 13 Feb 2025 |
Keywords
- Rheumatoid arthritis
- Psoriatic arthritis
- Axial spondyloarthritis
- Inflammatory arthritis
- Comorbidity
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Centre for Epidemiology Versus Arthritis.
Dixon, W. (PI), Bruce, I. (CoI), Felson, D. (CoI), Hyrich, K. (CoI), Lunt, M. (CoI), Mcbeth, J. (CoI), Mcdonagh, J. (CoI), O'Neill, T. (CoI), Sergeant, J. (CoI), Verstappen, S. (CoI) & Serafimova, I. (Support team)
1/08/18 → 31/07/25
Project: Research