Comorbidities of rheumatoid arthritis: A cross-sectional retrospective study

Abstract

Objective. Understanding comorbidities of rheumatoid arthritis (RA) and their burden definitely redefines the holistic approach of RA in daily practice. This study aimed to explore a range of comorbidities in patients with RA and to analyze their involvement in the choice of individualized treatment in real-life to achieve better disease outcomes. Material and method. A retrospective cross-sectional observational study in a cohort of 201 consecutive adult RA (diagnosed by either ACR 1987 or EULAR/ACR 2010 criteria) examining the association between comorbidities and different drug prescriptions for RA. Results. Comorbidities were recognized in 90% of patients; top five associated disorders were hypertension (n=106; 52.72%), osteoporosis (n=73; 36.32%), dyslipidemia (n=58; 28.86%), interstitial lung disease (n=43; 21.39%), chronic kidney disease (n=35; 17.41%). Antimalarials were the most commonly prescribed drugs (n=84; 41.79%) followed by methotrexate (n=76; 36.81%) and biologics (n=63; 31.34%) with a comparable distribution between TNF inhibitors (n=27; 13.43%) and anti-IL-6 drugs (n=28; 13.93); only 13 cases (6.47%) received tsDMARDs. 16% patients with concomitant hypertension, 11% with diabetes, 15% with osteoporosis and 15.52% with dyslipidemia received intermittent low doses of glucocorticoids. Reported in 24 cases (11.94%), hepatitis B and C significantly affect the use of medication, including bDMARDs (only 4 cases on etanercept given together with antivirals), while RA with interstitial lung disease received biologics in one third of cases. Conclusion. Exploring RA journey from the perspective of comorbidities in real-life underpins management challenges related to associated conditions as comorbidities of RA patients may impact treatment regimens of RA and/or the prescribed drugs may worsen associated disorders.