Association between Rheumatoid Arthritis Disease Activity and Comorbidities
DOI:
https://doi.org/10.56056/amj.2024.308Keywords:
BMI, Comorbidities, DAS28 Score, Rheumatoid ArthritisAbstract
Background and objectives: Rheumatoid arthritis is an autoimmune condition marked by chronic joint inflammation, frequently resulting in substantial impairment and diminished quality of life. However, rheumatoid arthritis rarely occurs in isolation, as individuals with this condition frequently present with comorbidities, such as cardiovascular disease, diabetes, and osteoporosis. Understanding the role of comorbidities in Rheumatoid Arthritis is critical for comprehensive patient care. The aim of this study was to investigate the impact of various comorbidities on disease activity of rheumatoid arthritis.
Methods: Patient data for this cross-sectional study was collected at rheumatology outpatient of Rizgary teaching hospital in Erbil city of Kurdistan-Iraq from August 2022 August 2023. Study participants included patients with rheumatoid arthritis with (n=60) and without (n=60) comorbidities and they were matched for age and sex.
Results: Our findings revealed that among patients with rheumatoid arthritis, hypertension is the most frequent comorbidity, affecting 27 patients (45%) of them. This is followed by the coexistence of hypertension and diabetes mellitus in 9 (15%) of cases, and hypothyroidism in 8 (13.3%) of cases. Furthermore, the study establishes a strong and statistically significant link between patient age and the presence of comorbidities (p<0.001). Additionally, it demonstrates a significant correlation between the high activity of RA disease and comorbidities (p=0.03).
Conclusions: This research is providing insights into the ways in which these accompanying medical conditions affect the activity of rheumatoid arthritis. The results of this current study have important implications for making treatment choices, assessing risks, and crafting customized approaches to managing this disease.
Downloads
References
Scott DL, Wolfe F, Huizinga TW. Rheumatoid arthritis. Lancet. 2010;376(9746):1094-108.
Kinne RW, Bräuer R, Stuhlmüller B, Palombo-Kinne E, Burmester GR. Macrophages in rheumatoid arthritis. Arthritis Res. 2000;2(3):189-202.
Martinez-Gamboa L, Brezinschek HP, Burmester GR, Dörner T. Immunopathologic role of B lymphocytes in rheumatoid arthritis: rationale of B cell-directed therapy. Autoimmun Rev. 2006;5(7):437-42.
Baillet A, Zeboulon N, Gossec L, Combescure C, Bodin LA, Juvin R, et al. Efficacy of cardiorespiratory aerobic exercise in rheumatoid arthritis: meta-analysis of randomized controlled trials. Arthritis Care Res (Hoboken). 2010;62(7):984-92.
Uhlig T, Moe RH, Kvien TK. The burden of disease in rheumatoid arthritis. Pharmacoeconomics. 2014;32(9):841-51.
Scherer HU, Häupl T, Burmester GR. The etiology of rheumatoid arthritis. J Autoimmun. 2020; 110:102400.
van der Woude D, Houwing-Duistermaat JJ, Toes RE, Huizinga TW, Thomson W, Worthington J, et al. Quantitative heritability of anti-citrullinated protein antibody-positive and anti-citrullinated protein antibody-negative rheumatoid arthritis. Arthritis Rheum. 2009;60(4):916-23.
Hammer J, Gallazzi F, Bono E, Karr RW, Guenot J, Valsasnini P, et al. Peptide binding specificity of HLA-DR4 molecules: correlation with rheumatoid arthritis association. J Exp Med. 1995;181(5):1847-55.
Gregersen PK, Silver J, Winchester RJ. The shared epitope hypothesis. An approach to understanding the molecular genetics of susceptibility to rheumatoid arthritis. Arthritis Rheum. 1987;30(11):1205-13.
Aletaha D, Smolen JS. Diagnosis and Management of Rheumatoid Arthritis: A Review. JAMA. 2018;320(13):1360-72.
Dougados M, Soubrier M, Antunez A, Balint P, Balsa A, Buch MH, et al. Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA). Ann Rheum Dis. 2014;73(1):62-8.
Wolfe F, Mitchell DM, Sibley JT, Fries JF, Bloch DA, Williams CA, et al. The mortality of rheumatoid arthritis. Arthritis Rheum. 1994;37(4):481-94.
Gabriel SE. Why do people with rheumatoid arthritis still die prematurely Ann Rheum Dis. 2008;67 Suppl 3(Suppl 3): iii30-4.
Liao KP, Solomon DH. Traditional cardiovascular risk factors, inflammation and cardiovascular risk in rheumatoid arthritis. Rheumatology (Oxford). 2013;52(1):45-52.
Symmons DP, Gabriel SE. Epidemiology of CVD in rheumatic disease, with a focus on RA and SLE. Nat Rev Rheumatol. 2011;7(7):399-408.
Aviña-Zubieta JA, Choi HK, Sadatsafavi M, Etminan M, Esdaile JM, Lacaille D. Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta-analysis of observational studies. Arthritis Rheum. 2008;59(12):1690-7.
Zohaib A, Rasheed A, Mahmud TE, Hayat U, Shabbir S, Riaz S, et al. Correlation of Hypothyroidism with Disease Activity Score-28 in Patients of Rheumatoid Arthritis. Cureus. 2022;14(6): e26382.
Alvarez-Nemegyei J, Pacheco-Pantoja E, González-Salazar M, López-Villanueva RF, May-Kim S, Martínez-Vargas L, et al. Association between Overweight/Obesity and Clinical Activity in Rheumatoid Arthritis. Reumatol Clin (Engl Ed). 2020;16(6):462-7.
Taylor PC, Atzeni F, Balsa A, Gossec L, Müller-Ladner U, Pope J. The Key Comorbidities in Patients with Rheumatoid Arthritis: A Narrative Review. J Clin Med. 2021;10(3).509.
Noori TA, Al-Sarray A, Al-Hafidh AH. Treatment Modalities and Comorbidities among Samples of Rheumatoid Arthritis in Baghdad Teaching Hospital, Baghdad, Iraq.Int. J. Pharm. Qual. 2021;12(2):60-4.
Al-Bishri J, Attar S, Bassuni N, Al-Nofaiey Y, Qutbuddeen H, Al-Harthi S, et al. Comorbidity profile among patients with rheumatoid arthritis and the impact on prescriptions trend. Clin Med Insights Arthritis Musculoskelet Disord. 2013; 6:11-8.
Jeong H, Baek SY, Kim SW, Eun YH, Kim IY, Kim H, et al. Comorbidities of rheumatoid arthritis: Results from the Korean National Health and Nutrition Examination Survey. PLoS One. 2017;12(4): e0176260.
van Onna M, Boonen A. The challenging interplay between rheumatoid arthritis, ageing and comorbidities. BMC Musculoskelet Disord. 2016; 17:184.
Mousavi SE, Nejadghaderi SA, Khabbazi A, Alizadeh M, Sullman MJ, Kaufman JS, et al. The burden of rheumatoid arthritis in the Middle East and North Africa region, 1990-2019. Sci Rep. 2022;12(1):19297.
Balsa A, Lojo-Oliveira L, Alperi-López M, García-Manrique M, Ordóñez-Cañizares C, Pérez L, et al. Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring in clinical practice: the spanish cohort of the COMORA study. Reumatol Clin (Engl Ed). 2019;15(2):102-8.
Tidblad L, Westerlind H, Delcoigne B, Askling J, Saevarsdottir S. Comorbidities and treatment patterns in early rheumatoid arthritis: a nationwide Swedish study. RMD Open. 2022;8(2).
Innala L, Sjöberg C, Möller B, Ljung L, Smedby T, Södergren A, et al. Co-morbidity in patients with early rheumatoid arthritis - inflammation matters. Arthritis Res Ther. 2016; 18:33.
Garip Y, Eser F, Bodur H. Comorbidities in Turkish patients with rheumatoid arthritis: association with the health-related quality of life in terms of disease activity, functional and radiological status, severity of pain, and social and emotional functioning. Acta Reumatol Port. 2016;41(4):344-9.
K?odzi?ski ?, Wis?owska M. Comorbidities in rheumatic arthritis. Reumatologia. 2018;56(4):228-33.
Jwad RK, Kadhim D, Alosami M, Shareef L. Medication-related burden among Iraqi patients with rheumatoid arthritis: An observational study. F1000Resaerch 2022;11: 1047.
Lu MC, Guo HR, Lin MC, Livneh H, Lai NS, Tsai TY. Bidirectional associations between rheumatoid arthritis and depression: a nationwide longitudinal study. Sci Rep. 2016;6: 20647.
Turesson C, Bergström U, Pikwer M, Nilsson J, Jacobsson LT. High serum cholesterol predicts rheumatoid arthritis in women, but not in men: a prospective study. Arthritis Res Ther. 2015; 17:284.
Fuller DT, Kedar E, Lovelett CR, Mondal S, Sur S. Prevalence of Common Comorbidities in Rheumatoid Arthritis in Rural New York Compared with National Data. Cureus. 2021;13(11): e19432.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Bahra Hussein Mohammed, Shwan Qadir Media
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in AMJ (The Scientific Journal of Kurdistan Higher Council of Medical Specialties )is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0)