THU0137 ASSESSING THE MULTIMORBID PROFILE (CIRS) IN RHEUMATOID ARTHRITIS. FIRST RESULTS.

Abstract

Background:Objectives:To assess the presence and nature of multimorbidity in patients with rheumatoid arthritis (RA) and the impact of multimorbidity on disease activity.Methods:The investigation enrolled 117 patients (mean age, 54.8±14.8 years) with RA according to the 2010 ACR/EULAR criteria, who had been examined and treated at the V.A. Nasonova Research Institute of Rheumatology in 2018–2019. The median disease duration was 5.0 [1.5; 9.5] years; the mean DAS28 score was 5.0±1.3. Documentation and anamnesis data were analyzed with emphasis on associated diseases. The Cumulative Illness Rating Scale (CIRS) was used to assess the profile of multimorbidity.Results:The patients with RA had a high index of the spectrum of multimorbidity; concomitant diseases were detected in 96 (82%) cases.The median number of diseases in one patient was 2 [1; 4], the mean total CIRS score was 6.7±3.3; the median value was 2.5 [1; 6]. The number of concomitant diseases diagnosed before using the CIRS was significantly lower (by 48%; p<0.01) than was found in the investigation conducted.Chronic kidney disease that occurred in almost half (42.5%) of cases was most commonly undiagnosed in the cohort under study; on average, every three patients were not found to have signs of metabolic syndrome (hyperglycemia in 29%, hypercholesterolemia in 20%, obesity in 13.5%), chronic hypoxia (new-onset anemia verified in 24% of cases). In 12% of cases lung damages were not found before using the CIRS. There was a correlation of the quantitative equivalent of multimorbidity with the clinical and laboratory measures of RA activity, including the number of painful joints (r = 0.39; p<0.001), overall patient assessment (r=0.37; p=0.03), physician’s global assessment of disease activity (r = 0.37; p < 0.01), DAS28 (r = 0.42; p<0.001), CDAI (r=0.37; p<0.001), SDAI (r=0.34; p< 0.001), HAQ (r=0.34; p<0.001). The total CIRS score did not differ in patients with early- and advanced- or end-stage RA: 6.6±3.5 and 6.7±3.3, respectively (p=0.9).Conclusion:A systematic screening of multimorbidity should be carried out in all patients with RA. It is advisable to use the CIRS to estimate the prevalence of multimorbidity, its consequences and the risk factors for the development of multimorbidity in the long term.Disclosure of Interests:None declared