COMORBIDITY IN PATIENTS WITH RHEUMATOID ARTHRITIS
https://doi.org/10.14412/1995-4484-2015-149-154
Abstract
Objective: to study the pattern and rate of comorbid diseases in patients with rheumatoid arthritis (RA) in the Saratov Region.
Subjects and methods. The investigation enrolled 328 RA patients treated at the Rheumatology Unit, Saratov Regional Clinical Hospital, in 2011 to 2013. RA was diagnosed using the 1987 ACR criteria and the 2010 ACR/EULAR ones. The investigation included the patients receiving disease-modifying antirheumatic drugs (DMARD) at a stable dose for 3 months or longer. A questionnaire survey and objective examination were made in the patients; data from their medical records were taken into account.
Results and discussion. Comorbidities were identified in 86.6% of the patients; 57.9% had a concurrence of two or more comorbid conditions. Osteoarthritis, hypertension, and coronary heart disease were detected in 50.7, 57.7, and 30.9% of the RA patients, respectively. Out of the inflammatory diseases, gastrointestinal tract lesion was most common (80.3%); urinary tract infections were slightly less common (19.7%).
Conclusion. The high rate of comorbidity was noted in patients with RA. The pattern of comorbidities shows a preponderance of hypertension and osteoarthritis and an exacerbation of gastrointestinal and urinary tract diseases frequently makes the choice of DMARD difficult.
About the Authors
N. M. Nikitina
V.I. Razumovsky Saratov State Medical University
Russian Federation
Competing Interests:
Russian Federation
Competing Interests:
Contact: Natalia Nikitina; nikitina02@yandex.ru
I. A. Afanasyev
V.I. Razumovsky Saratov State Medical University
Russian Federation
Russian Federation
A. P. Rebrov
V.I. Razumovsky Saratov State Medical University
Russian Federation
Russian Federation
References
1. Верткин АЛ, Румянцев МА, Скотников АС и др. Коморбидность. Вестник семейной медицины. 2011;(3):40–7. [Vertkin AL, Rumiancev MA, Scotnikov AC, et al. Comorbidity. Bull Family Med. 2011;(3):40–7. (In Russ.)].
2. Гордеев АВ, Галушко ЕА, Насонов ЕЛ. Концепция мультиморбидности в ревматологической практике. Научнопрактическая ревматология. 2014;52(4):362–5. [Gordeev AV, Galushko EA, Nasonov EL. The concept of multimorbidity in rheumatologic practice. Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practice. 2014;52(4):362–5. (In Russ.)]. doi: http://dx.doi.org/10.14412/1995-4484-2014-362-365
3. Панафидина ТА, Кондратьева ЛВ, Герасимова ЕВ и др. Коморбидность при ревматоидном артрите. Научнопрактическая ревматология. 2014;52(3):283–9 [Panafidina TA, Kondratieva LV, Gerasimova EV, et al. Comorbidity in rheumatoid arthritis. Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practice. 2014;52(3):283–9. (In Russ.)]. doi: http://dx.doi.org/10.14412/1995-4484-2014-283-289
4. Pasceri V, Yeh ETH. A tale of two diseases. Atherosclerosis and rheumatoid arthritis. Circulation. 1999;100:2124–6. doi: 10.1161/01.CIR.100.21.2124
5. Sattar N, McCrey DW, Capell H, McInnes IB. Explaining how «high-grade» systemic inflammation accelerated vascular risk in rheumatoid arthritis. Circulation. 2003;108:2957–63. doi: 10.1161/01.CIR.0000099844.31524.05
6. Boers M, Dijkmans B, Gabriel S, et al. Making an impact on mortality in rheumatoid arthritis. Targeting cardiovascular comorbidity. Arthritis Rheum. 2004;50:1734–9. doi: http://dx.doi.org/10.1002/art.20306
7. Gabriel SE, Crowson CS, Kremers HM, et al. Survival in rheumatoid arthritis: a population-based analysis of trends over 40 years. Arthritis Rheum. 2003;48:54–8. doi: 10.1002/art.10705
8. Kitas GD, Erb N. Tackling ischemic heart disease in rheumatoid arthritis. Rheumatology. 2003;42:607–13. doi: 10.1093/rheumatology/keg175
9. Jurgens MS, Jacobs JW, Bijlsma JW. The use of conventional disease-modifying anti-rheumatic drugs in established RA. Best Pract Res Clin Rheumatol. 2011;25(4):523–33. doi: 10.1016/j.berh.2011.10.006
10. Smolen JS, Aletaha D, Bijlsma JW, et al. Treating rheumatoid arthritis to target: recommendations of an international task force. Ann Rheum Dis. 2010;69(4):631–7. doi: 10.1136/ard.2009.123919
11. Charlson ME. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis. 1987;40(5):373–83. doi: 10.1016/0021-9681(87)90171-8
12. Gabriel SE, Michaud K. Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases. Arthritis Res Ther. 2009;11(3):229. doi 10.1186/ar2669
13. Wolfe F, Mitchell DM, SibleyJT, et al. The mortality of rheumatoid arthritis. Arthritis Rheum. 1994;37(4);481–94. doi: 10.1002/art.1780370408
14. Насонов ЕЛ, Каратеев ДЕ, Чичасова НВ. Рекомендации EULAR по лечению ревматоидного артрита – 2013: общая характеристика и дискуссионные проблемы. Научнопрактическая ревматология. 2013;51 (6):609–22. [Nasonov EL, Karateev DE, Chichasova NV. EULAR recommendations for the treatment of rheumatoid arthritis – 2013: general characteristics and disputable problems. Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practice. 2013;51(6):609–22. (In Russ.)]. doi: 10.14412/1995-4484-2013-609-22
15. Smolen JS, Landewe R, Breedveld FC, et al. EULAR recomendattions for the management of rheumatoid arthritis with syntethetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis. 2014;73:492–509. doi: 10.1136/annrheumdis-2013- 204573
16. Maradit-Kremers H, Nicola PJ, Crowsoon CS, et al. Cardiovascular death in rheumatoid arthritis. Arthritis Rheum. 2005;52:722–32. doi: 10.1002/art.20878
17. Попкова ТВ, Новикова ДС, Насонов ЕЛ. Атеротромбоз при аутоиммунных заболеваниях: современное стояние проблемы. Consilium medicum. 2008;10(11):128–35. [Popkova TV, Novicova DS, Nasonov EL. Aterotromboz at autoimmune diseases: current state of a problem. Consilium medicum. 2008;10(11):128–35. (In Russ.)].
Review
For citations:
Nikitina N.M., Afanasyev I.A., Rebrov A.P. COMORBIDITY IN PATIENTS WITH RHEUMATOID ARTHRITIS. Rheumatology Science and Practice. 2015;53(2):149-154. (In Russ.) https://doi.org/10.14412/1995-4484-2015-149-154
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