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Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA).

Abstract：

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.

journal_name

Ann Rheum Dis

journal_title

Annals of the rheumatic diseases

authors

Dougados M,Soubrier M,Antunez A,Balint P,Balsa A,Buch MH,Casado G,Detert J,El-Zorkany B,Emery P,Hajjaj-Hassouni N,Harigai M,Luo SF,Kurucz R,Maciel G,Mola EM,Montecucco CM,McInnes I,Radner H,Smolen JS,Song YW,Von

doi

10.1136/annrheumdis-2013-204223

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

62-8

issue

eissn

0003-4967

issn

1468-2060

pii

annrheumdis-2013-204223

journal_volume

pub_type

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Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA).