COMORBIDITY IN RHEUMATOID ARTHRITIS
https://doi.org/10.14412/1995-4484-2014-283-289
Abstract
The peak onset of rheumatoid arthritis (RA) is at 30-55 years of age. At this age, the patients have also other concomi- tant diseases (comorbidities) that affect the course and prognosis of RA, the choice of its treatment policy, quality of life of the patients.
Objective: to identify the most important and common comorbidities in patients with RA.
Subjects and methods. Two hundred patients (median age 55 [46; 61] years) were enrolled; there was a preponderance of women (82.5%) with median disease duration 5 [1; 10] years, seropositive for IgM rheumatoid factor (83.0%) and anti-cyclic citrullinated peptide antibodies (81.6%) with moderate and high disease activity (median DAS28 value 3.9 [3.1; 4.9]). Varying degrees of destructive changes in hand and foot joints were radiologically detected in 71.2% of the patients; 64.5% of the patients had Functional Class II. Methotrexate was given to 69.5% of the patients; therapy with biological agents was used in 21.0% of the cases. 15.5% of the patients did not receive DMARD or biologics. 43.0% of the patients with RA received glucocorticoids.
Results. Comorbidities were present in 72.0% of the patients with RA. The most common diseases were hypertension (60.0%), dyslipidemia (45.0%), fractures at various sites (29.5%), and coronary heart disease (21.0%). Myocardial infarction and stroke were observed in 1.5 and 1.0% of cases, respectively. There was diabetes mellitus (DM) in 7.5% of the cases and osteoporosis in 15.5% of the patients. 81.7% of the patients with RA and hypertension and 80.0% of those with RA and DM received antihypertensive and sugar-lowering therapy, respectively. At the same time the RA patients with dyslipidemia and osteoporosis received specific drugs far less frequently (30.0 and 29.0%, respectively). Conclusion. Comorbidities are frequently encountered in RA. By taking into account the fact that cardiovascular dis- eases are a main cause of death in RA; it is necessary to adequately and timely modify traditional risk factors (hyper- tension, dyslipidemia, and diabetes mellitus). Treatment patients with RA requires an interdisciplinary approach and an interaction between physicians of different specialties.
About the Authors
T. A. Panafidina
Nasonova Research Institute of Rheumatology, Moscow, Russia
Russian Federation
Russian Federation
L. V. Kondratyeva
Nasonova Research Institute of Rheumatology, Moscow, Russia
E. V. Gerasimova
Nasonova Research Institute of Rheumatology, Moscow, Russia
D. S. Novikova
Nasonova Research Institute of Rheumatology, Moscow, Russia
T. V. Popkova
Nasonova Research Institute of Rheumatology, Moscow, Russia
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Panafidina T.A., Kondratyeva L.V., Gerasimova E.V., Novikova D.S., Popkova T.V. COMORBIDITY IN RHEUMATOID ARTHRITIS. Rheumatology Science and Practice. 2014;52(3):283-289. (In Russ.) https://doi.org/10.14412/1995-4484-2014-283-289
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