Co-morbidity in patients with early rheumatoid arthritis - inflammation matters
Abstract Background Patients with rheumatoid arthritis (RA) suffer from co-morbidities that contribute to a shortened lifespan. Inflammation is important for the development of cardiovascular disease, but little is known on its relationship with other co-morbidities. We investigated the role of infl...
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ftbiomed:oai:biomedcentral.com:s13075-016-0928-y 2023-05-15T17:45:12+02:00 Co-morbidity in patients with early rheumatoid arthritis - inflammation matters Innala, Lena Sjöberg, Clara Möller, Bozena Ljung, Lotta Smedby, Torgny Södergren, Anna Magnusson, Staffan Rantapää-Dahlqvist, Solbritt Wållberg-Jonsson, Solveig 2016-01-28 http://arthritis-research.com/content/18/1/33 en eng BioMed Central Ltd. http://arthritis-research.com/content/18/1/33 Copyright 2016 Innala et al. Early rheumatoid arthritis Co-morbidity Inflammation Research article 2016 ftbiomed 2016-01-31T01:08:27Z Abstract Background Patients with rheumatoid arthritis (RA) suffer from co-morbidities that contribute to a shortened lifespan. Inflammation is important for the development of cardiovascular disease, but little is known on its relationship with other co-morbidities. We investigated the role of inflammation for the development of new comorbidities in early RA. Methods Since 1995, all patients with early RA in Northern Sweden are included in a prospective study on co-morbidities, with a total of 950 patients being included. At the time for this study, 726 had been ill for ≥5 years. Data on co-morbidities, clinical and laboratory disease activity and pharmacological therapy were collected from patient records and further validated using a questionnaire at RA onset (T0) and after 5 years (T5). Results Of the patients, 53.2 % of the patients had one or more co-morbidity at onset, the commonest being: hypertension (27.3 %), obstructive pulmonary disease (13.9 %), diabetes (8.0 %), hypothyroidism (6.3 %) and malignancy (5.0 %). After 5 years, 41.0 % had developed at least one new co-morbidity, the most common being: hypertension (15.1 %), malignancy (7.6 %), stroke/transient ischemic accident (5.1 %), myocardial infarction (4.3 %) and osteoporosis (3.7 %). Age at disease onset, a raised erythrocyte sedimentation rate (ESR) at inclusion, previous treatment with glucocorticoids (GC; p < 0.001 for all), extra-articular RA (Ex-RA; p < 0.01), DAS28 (area under the curve) at 24 months (p < 0.05), previous smoking at inclusion (p = 0.058) and male gender (p < 0.01) were associated with a new co-morbidity overall at T5. Treatment with biologics (p < 0.05) reduced the risk. In multiple logistic regression modelling, ESR (p = 0.036) at inclusion was associated with a new co-morbidity after 5 years, adjusted for age, sex, smoking and GC treatment. In a similar model, Ex-RA (p < 0.05) was associated with a new co-morbidity at T5. In a third model, adjusted for age and sex, a new pulmonary co-morbidity was associated with a smoking history at inclusion (p < 0.01), but not with ESR. Conclusion There was substantial co-morbidity among early RA patients already at disease onset, with considerable new co-morbidity being added during the first . Article in Journal/Newspaper Northern Sweden BioMed Central |
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Early rheumatoid arthritis Co-morbidity Inflammation |
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Early rheumatoid arthritis Co-morbidity Inflammation Innala, Lena Sjöberg, Clara Möller, Bozena Ljung, Lotta Smedby, Torgny Södergren, Anna Magnusson, Staffan Rantapää-Dahlqvist, Solbritt Wållberg-Jonsson, Solveig Co-morbidity in patients with early rheumatoid arthritis - inflammation matters |
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Early rheumatoid arthritis Co-morbidity Inflammation |
description |
Abstract Background Patients with rheumatoid arthritis (RA) suffer from co-morbidities that contribute to a shortened lifespan. Inflammation is important for the development of cardiovascular disease, but little is known on its relationship with other co-morbidities. We investigated the role of inflammation for the development of new comorbidities in early RA. Methods Since 1995, all patients with early RA in Northern Sweden are included in a prospective study on co-morbidities, with a total of 950 patients being included. At the time for this study, 726 had been ill for ≥5 years. Data on co-morbidities, clinical and laboratory disease activity and pharmacological therapy were collected from patient records and further validated using a questionnaire at RA onset (T0) and after 5 years (T5). Results Of the patients, 53.2 % of the patients had one or more co-morbidity at onset, the commonest being: hypertension (27.3 %), obstructive pulmonary disease (13.9 %), diabetes (8.0 %), hypothyroidism (6.3 %) and malignancy (5.0 %). After 5 years, 41.0 % had developed at least one new co-morbidity, the most common being: hypertension (15.1 %), malignancy (7.6 %), stroke/transient ischemic accident (5.1 %), myocardial infarction (4.3 %) and osteoporosis (3.7 %). Age at disease onset, a raised erythrocyte sedimentation rate (ESR) at inclusion, previous treatment with glucocorticoids (GC; p < 0.001 for all), extra-articular RA (Ex-RA; p < 0.01), DAS28 (area under the curve) at 24 months (p < 0.05), previous smoking at inclusion (p = 0.058) and male gender (p < 0.01) were associated with a new co-morbidity overall at T5. Treatment with biologics (p < 0.05) reduced the risk. In multiple logistic regression modelling, ESR (p = 0.036) at inclusion was associated with a new co-morbidity after 5 years, adjusted for age, sex, smoking and GC treatment. In a similar model, Ex-RA (p < 0.05) was associated with a new co-morbidity at T5. In a third model, adjusted for age and sex, a new pulmonary co-morbidity was associated with a smoking history at inclusion (p < 0.01), but not with ESR. Conclusion There was substantial co-morbidity among early RA patients already at disease onset, with considerable new co-morbidity being added during the first . |
format |
Article in Journal/Newspaper |
author |
Innala, Lena Sjöberg, Clara Möller, Bozena Ljung, Lotta Smedby, Torgny Södergren, Anna Magnusson, Staffan Rantapää-Dahlqvist, Solbritt Wållberg-Jonsson, Solveig |
author_facet |
Innala, Lena Sjöberg, Clara Möller, Bozena Ljung, Lotta Smedby, Torgny Södergren, Anna Magnusson, Staffan Rantapää-Dahlqvist, Solbritt Wållberg-Jonsson, Solveig |
author_sort |
Innala, Lena |
title |
Co-morbidity in patients with early rheumatoid arthritis - inflammation matters |
title_short |
Co-morbidity in patients with early rheumatoid arthritis - inflammation matters |
title_full |
Co-morbidity in patients with early rheumatoid arthritis - inflammation matters |
title_fullStr |
Co-morbidity in patients with early rheumatoid arthritis - inflammation matters |
title_full_unstemmed |
Co-morbidity in patients with early rheumatoid arthritis - inflammation matters |
title_sort |
co-morbidity in patients with early rheumatoid arthritis - inflammation matters |
publisher |
BioMed Central Ltd. |
publishDate |
2016 |
url |
http://arthritis-research.com/content/18/1/33 |
genre |
Northern Sweden |
genre_facet |
Northern Sweden |
op_relation |
http://arthritis-research.com/content/18/1/33 |
op_rights |
Copyright 2016 Innala et al. |
_version_ |
1766148028479045632 |