Chinese Registry of rheumatoid arthritis (CREDIT): II.\xa0prevalence and risk factors of major comorbidities in Chinese patients with rheumatoid arthritis

Shangyi Jin,Xinwang Duan,Xiaofei Shi,Yi Liu,Qian Wang,Rui Wu,Zhenyu Jiang,Yongfu Wang,Chen Yu,Yan Zhao,Yanhong Wang,Xinping Tian,Yongfei Fang,Mengtao Li,Xiaofeng Zeng,Ju Liu,Qin Li

doi:10.1186/s13075-017-1457-z

Abstract

BackgroundRheumatoid arthritis patients are at higher risk of developing comorbidities. The main objective of this study was to evaluate the prevalence of major comorbidities in Chinese rheumatoid arthritis patients. We also aimed to identify factors associated with these comorbidities.MethodsBaseline demographic, clinical characteristics and comorbidity data from RA patients enrolled in the Chinese Registry of rhEumatoiD arthrITis (CREDIT) from Nov 2016 to August 2017 were presented and compared with those from five other registries across the world. Possible factors related to three major comorbidities (cardiovascular disease, fragility fracture and malignancy) were identified using multivariate logistic regression analyses.ResultsA total of 13,210 RA patients were included (80.6% female, mean age 52.9 years and median RA duration 4.0 years). Baseline prevalence rates of major comorbidities were calculated: CVD, 2.2% (95% CI 2.0–2.5%); fragility fracture, 1.7% (95% CI 1.5–1.9%); malignancy, 0.6% (95% CI 0.5–0.7%); overall major comorbidities, 4.2% (95% CI 3.9–4.6%). Advanced age was associated with all comorbidities. Male gender and disease duration were positively related to CVD. Female sex and longer disease duration were potential risk factors for fragility fractures. Ever use of methotrexate (MTX) was negatively related to baseline comorbidities.ConclusionsPatients with rheumatoid arthritis in China have similar prevalence of comorbidities with other Asian countries. Advanced age and long disease duration are possible risk factors for comorbidities. On the contrary, MTX may protect RA patients from several major comorbidities, supporting its central role in the management of rheumatoid arthritis.

Highlights

Rheumatoid arthritis patients are at higher risk of developing comorbidities
Over 83% of the patients were seropositive for either rheumatoid factor (RF) or anti-Anti-citrullinated protein antibody (CCP) antibody, and the mean disease activity score 28 (DAS28) was 4.5. 40.6% of the patients had been treated with glucocorticoid (GC), and approximately 55.9%, 45.9%, 30.4%, 4.4%, and 8.3% of them had received methotrexate (MTX), leflunomide (LEF), hydroxychloroquine (HCQ), sulfasalazine (SSZ) and biologic disease-modifying antirheumatic drugs therapies, respectively
Advanced age was associated with all comorbidities, consistent with the consensus that aging is a traditional risk factor for cardiovascular disease (CVD), osteoporotic fracture, and malignancy

Summary

Introduction

Rheumatoid arthritis patients are at higher risk of developing comorbidities. To better understand the presence and development of comorbidities in RA patients, several registries and cohorts all over the world have included related information in their data collection. Baseline data for prior and current comorbidities are collected at enrollment, and during follow-up visits incident conditions are captured [17]. These data provide information about the prevalence, incidence, risk factors and other characteristics of selected comorbidities, which may further be referred by rheumatologists to improve comorbidity detection and management strategies

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