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

Maxime Dougados, Martin Soubrier, Anna Antunez, Peter Balint, Alejandro Balsa, Maya H. Buch, Gustavo Casado, Jacqueline Detert, Bassel El-Zorkany, Paul Emery, Najia Hajjaj-Hassouni, Masayoshi Harigai, Shue Fen Luo, Reka Kurucz, Gabriel Maciel, Emilio Martin Mola, Carlo Maurizio Montecucco, Iain McInnes, Helga Radner, Josef S. SmolenYeong Wook Song, Harald Erwin Vonkeman, Kevin Winthrop, Jonathan Kay

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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.

Original languageEnglish
Pages (from-to)62-68
Number of pages7
JournalAnnals of the rheumatic diseases
Volume73
Issue number1
DOIs
Publication statusPublished - Jan 2014

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology
  • Biochemistry, Genetics and Molecular Biology(all)

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    Dougados, M., Soubrier, M., Antunez, A., Balint, P., Balsa, A., Buch, M. H., Casado, G., Detert, J., El-Zorkany, B., Emery, P., Hajjaj-Hassouni, N., Harigai, M., Luo, S. F., Kurucz, R., Maciel, G., Mola, E. M., Montecucco, C. M., McInnes, I., Radner, H., ... Kay, J. (2014). Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: Results of an international, cross-sectional study (COMORA). Annals of the rheumatic diseases, 73(1), 62-68. https://doi.org/10.1136/annrheumdis-2013-204223