Patients With RA Often Have Chronic Comorbidities

Multiple morbidities are more common in patients with rheumatoid arthritis (RA) both at RA diagnosis and throughout the disease course compared with matched counterparts without RA, according to a population-based study published in The Journal of Rheumatology.

“These findings underscore the complexity of caring for patients with RA, since a large proportion of these patients have multiple chronic conditions,” wrote researchers from the Mayo Clinic. “This complexity makes healthcare decision-making more challenging than in patients without RA. In addition, patients with rheumatic diseases are less likely to receive optimal health maintenance and preventive care services.”

The study included 597 residents of Olmsted County, Minnesota, with incident RA and 594 age- and sex-matched residents without RA. Researchers investigated for the presence of 25 chronic comorbidities, excluding rheumatic comorbidities, at RA incidence and after a median 11 years of follow-up.

At RA incidence, 38% of patients with RA had 2 or more chronic comorbidities compared with 32% of people without RA. The prevalence of 5 or more chronic morbidities was 5% among patients with RA compared with 4% among people without RA.

After 10 years of follow-up, the cumulative incidence of 2 or more chronic comorbidities was 56.5% among patients with RA and 47.9% among counterparts without RA, the study found. Researchers found no increase in the incidence of 5 or more chronic comorbidities in patients with RA at follow-up.

Regarding specific comorbidities, the study identified increased prevalence and incidence of hypertension, hypothyroidism, chronic pulmonary disease, deficiency anemias, depression, and liver disease among patients with RA.

“More research is needed, both to interpret possible disease clusters or trajectories within the accumulation of these comorbidities and to define strategies to reduce the comorbidity burden for patients with RA,” researchers advised.

—Jolynn Tumolo

Reference:

Gunderson TM, Myasoedova E, Davis JM 3rd, Crowson CS. Multimorbidity burden in rheumatoid arthritis: a population-based cohort study. J Rheumatol. 2021;48(11):1648-1654.