Takeaway
Multiple long-term conditions (LTCs) were common in patients with rheumatoid arthritis (RA).
Patients with RA and other LTCs, particularly comorbid osteoporosis, were at an increased risk of all-cause mortality and major adverse cardiovascular events (MACE).
Why this matters
Future clinical guidelines for RA should acknowledge the importance of multimorbidity when considering management planning and patient outcomes.
Study design
This population-based study used data from the UK Biobank to evaluate the effect of multimorbidity and a wide range of comorbid LTCs (n=42) on all-cause mortality and MACE in patients with RA (n=5658).
Funding: Versus Arthritis.
Key results
Overall, 75.7% of patients with RA had multimorbidity (34.5% of participants had 2-3 LTCs and 11.1% had ≥4 LTCs).
The risk of all-cause mortality was increased in patients with RA and additional LTC:
RA and 1 LTC (adjusted HR [aHR], 1.44; 95% CI, 1.14-1.81);
RA and 2-3 LTCs (aHR, 2.48; 95% CI, 2.12-2.90); and
RA and ≥4 LTCs (aHR, 3.30; 95% CI, 2.61-4.16).
Similarly, the risk of MACE was increased with:
RA and 1 LTC (aHR, 1.68; 95% CI, 1.31-2.15);
RA and 2-3 LTCs (aHR, 2.09; 95% CI, 1.73-2.54); and
RA and ≥4 LTCs (aHR, 3.39; 95% CI, 2.61-4.40).
Of the comorbid LTCs studied, osteoporosis was most strongly associated with adverse outcomes in patients with RA:
all-cause mortality (aHR, 2.20; 95% CI, 1.55-3.12); and
MACE (aHR, 3.17; 95% CI, 2.17-4.64).
Limitations
Data on RA and LTCs were self-reported.
Lack of information on RA disease severity.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Sarfaroj Khan. Multimorbidity and Adverse Outcomes in Rheumatoid Arthritis - Medscape - Dec 03, 2020.
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