Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: Results of an international, cross-sectional study (COMORA)

Maxime Dougados, Martin Soubrier, Anna Antunez, Peter Balint, Alejandro Balsa, Maya H. Buch, Gustavo Casado, Jacqueline Detert, Bassel El-Zorkany, Paul Emery, Najia Hajjaj-Hassouni, Masayoshi Harigai, Shue Fen Luo, Reka Kurucz, Gabriel Maciel, Emilio Martin Mola, Carlo Maurizio Montecucco, Iain McInnes, Helga Radner, Josef S. SmolenYeong Wook Song, Harald Erwin Vonkeman, Kevin Winthrop, Jonathan Kay

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Abstract

Background Patients with rheumatoid arthritis (RA) are at increased risk of developing comorbid conditions. Objectives To evaluate the prevalence of comorbidities and compare their management in RA patients from different countries worldwide. Methods Study design: international, cross-sectional. Patients: consecutive RA patients. Data collected: demographics, disease characteristics (activity, severity, treatment), comorbidities (cardiovascular, infections, cancer, gastrointestinal, pulmonary, osteoporosis and psychiatric disorders). Results Of 4586 patients recruited in 17 participating countries, 3920 were analysed (age, 56±13 years; disease duration, 10±9 years (mean±SD); female gender, 82%; DAS28 (Disease Activity Score using 28 joints)-erythrocyte sedimentation rate, 3.7±1.6 (mean±SD); Health Assessment Questionnaire, 1.0±0.7 (mean±SD); past or current methotrexate use, 89%; past or current use of biological agents, 39%. The most frequently associated diseases (past or current) were: depression, 15%; asthma, 6.6%; cardiovascular events (myocardial infarction, stroke), 6%; solid malignancies (excluding basal cell carcinoma), 4.5%; chronic obstructive pulmonary disease, 3.5%. High intercountry variability was observed for both the prevalence of comorbidities and the proportion of subjects complying with recommendations for preventing and managing comorbidities. The systematic evaluation of comorbidities in this study detected abnormalities in vital signs, such as elevated blood pressure in 11.2%, and identified conditions that manifest as laboratory test abnormalities, such as hyperglycaemia in 3.3% and hyperlipidaemia in 8.3%. Conclusions Among RA patients, there is a high prevalence of comorbidities and their risk factors. In this multinational sample, variability among countries was wide, not only in prevalence but also in compliance with recommendations for preventing and managing these comorbidities. Systematic measurement of vital signs and laboratory testing detects otherwise unrecognised comorbid conditions.

Original languageEnglish (US)
Pages (from-to)62-68
Number of pages7
JournalAnnals of the Rheumatic Diseases
Volume73
Issue number1
DOIs
StatePublished - Jan 2014

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Comorbidity
Rheumatoid Arthritis
Cross-Sectional Studies
Monitoring
Vital Signs
Pulmonary diseases
Blood pressure
Biological Factors
Sedimentation
Methotrexate
Cardiovascular Infections
Cells
Health
Gastrointestinal Neoplasms
Basal Cell Carcinoma
Blood Sedimentation
Hyperlipidemias
Hyperglycemia
Testing
Chronic Obstructive Pulmonary Disease

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Allergy

Cite this

Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring : Results of an international, cross-sectional study (COMORA). / Dougados, Maxime; Soubrier, Martin; Antunez, Anna; Balint, Peter; Balsa, Alejandro; Buch, Maya H.; Casado, Gustavo; Detert, Jacqueline; El-Zorkany, Bassel; Emery, Paul; Hajjaj-Hassouni, Najia; Harigai, Masayoshi; Luo, Shue Fen; Kurucz, Reka; Maciel, Gabriel; Mola, Emilio Martin; Montecucco, Carlo Maurizio; McInnes, Iain; Radner, Helga; Smolen, Josef S.; Song, Yeong Wook; Vonkeman, Harald Erwin; Winthrop, Kevin; Kay, Jonathan.

In: Annals of the Rheumatic Diseases, Vol. 73, No. 1, 01.2014, p. 62-68.

Research output: Contribution to journalArticle

Dougados, M, Soubrier, M, Antunez, A, Balint, P, Balsa, A, Buch, MH, Casado, G, Detert, J, El-Zorkany, B, Emery, P, Hajjaj-Hassouni, N, Harigai, M, Luo, SF, Kurucz, R, Maciel, G, Mola, EM, Montecucco, CM, McInnes, I, Radner, H, Smolen, JS, Song, YW, Vonkeman, HE, Winthrop, K & Kay, J 2014, 'Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: Results of an international, cross-sectional study (COMORA)', Annals of the Rheumatic Diseases, vol. 73, no. 1, pp. 62-68. https://doi.org/10.1136/annrheumdis-2013-204223
Dougados, Maxime ; Soubrier, Martin ; Antunez, Anna ; Balint, Peter ; Balsa, Alejandro ; Buch, Maya H. ; Casado, Gustavo ; Detert, Jacqueline ; El-Zorkany, Bassel ; Emery, Paul ; Hajjaj-Hassouni, Najia ; Harigai, Masayoshi ; Luo, Shue Fen ; Kurucz, Reka ; Maciel, Gabriel ; Mola, Emilio Martin ; Montecucco, Carlo Maurizio ; McInnes, Iain ; Radner, Helga ; Smolen, Josef S. ; Song, Yeong Wook ; Vonkeman, Harald Erwin ; Winthrop, Kevin ; Kay, Jonathan. / Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring : Results of an international, cross-sectional study (COMORA). In: Annals of the Rheumatic Diseases. 2014 ; Vol. 73, No. 1. pp. 62-68.
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abstract = "Background Patients with rheumatoid arthritis (RA) are at increased risk of developing comorbid conditions. Objectives To evaluate the prevalence of comorbidities and compare their management in RA patients from different countries worldwide. Methods Study design: international, cross-sectional. Patients: consecutive RA patients. Data collected: demographics, disease characteristics (activity, severity, treatment), comorbidities (cardiovascular, infections, cancer, gastrointestinal, pulmonary, osteoporosis and psychiatric disorders). Results Of 4586 patients recruited in 17 participating countries, 3920 were analysed (age, 56±13 years; disease duration, 10±9 years (mean±SD); female gender, 82{\%}; DAS28 (Disease Activity Score using 28 joints)-erythrocyte sedimentation rate, 3.7±1.6 (mean±SD); Health Assessment Questionnaire, 1.0±0.7 (mean±SD); past or current methotrexate use, 89{\%}; past or current use of biological agents, 39{\%}. The most frequently associated diseases (past or current) were: depression, 15{\%}; asthma, 6.6{\%}; cardiovascular events (myocardial infarction, stroke), 6{\%}; solid malignancies (excluding basal cell carcinoma), 4.5{\%}; chronic obstructive pulmonary disease, 3.5{\%}. High intercountry variability was observed for both the prevalence of comorbidities and the proportion of subjects complying with recommendations for preventing and managing comorbidities. The systematic evaluation of comorbidities in this study detected abnormalities in vital signs, such as elevated blood pressure in 11.2{\%}, and identified conditions that manifest as laboratory test abnormalities, such as hyperglycaemia in 3.3{\%} and hyperlipidaemia in 8.3{\%}. Conclusions Among RA patients, there is a high prevalence of comorbidities and their risk factors. In this multinational sample, variability among countries was wide, not only in prevalence but also in compliance with recommendations for preventing and managing these comorbidities. Systematic measurement of vital signs and laboratory testing detects otherwise unrecognised comorbid conditions.",
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T2 - Results of an international, cross-sectional study (COMORA)

AU - Dougados, Maxime

AU - Soubrier, Martin

AU - Antunez, Anna

AU - Balint, Peter

AU - Balsa, Alejandro

AU - Buch, Maya H.

AU - Casado, Gustavo

AU - Detert, Jacqueline

AU - El-Zorkany, Bassel

AU - Emery, Paul

AU - Hajjaj-Hassouni, Najia

AU - Harigai, Masayoshi

AU - Luo, Shue Fen

AU - Kurucz, Reka

AU - Maciel, Gabriel

AU - Mola, Emilio Martin

AU - Montecucco, Carlo Maurizio

AU - McInnes, Iain

AU - Radner, Helga

AU - Smolen, Josef S.

AU - Song, Yeong Wook

AU - Vonkeman, Harald Erwin

AU - Winthrop, Kevin

AU - Kay, Jonathan

PY - 2014/1

Y1 - 2014/1

N2 - Background Patients with rheumatoid arthritis (RA) are at increased risk of developing comorbid conditions. Objectives To evaluate the prevalence of comorbidities and compare their management in RA patients from different countries worldwide. Methods Study design: international, cross-sectional. Patients: consecutive RA patients. Data collected: demographics, disease characteristics (activity, severity, treatment), comorbidities (cardiovascular, infections, cancer, gastrointestinal, pulmonary, osteoporosis and psychiatric disorders). Results Of 4586 patients recruited in 17 participating countries, 3920 were analysed (age, 56±13 years; disease duration, 10±9 years (mean±SD); female gender, 82%; DAS28 (Disease Activity Score using 28 joints)-erythrocyte sedimentation rate, 3.7±1.6 (mean±SD); Health Assessment Questionnaire, 1.0±0.7 (mean±SD); past or current methotrexate use, 89%; past or current use of biological agents, 39%. The most frequently associated diseases (past or current) were: depression, 15%; asthma, 6.6%; cardiovascular events (myocardial infarction, stroke), 6%; solid malignancies (excluding basal cell carcinoma), 4.5%; chronic obstructive pulmonary disease, 3.5%. High intercountry variability was observed for both the prevalence of comorbidities and the proportion of subjects complying with recommendations for preventing and managing comorbidities. The systematic evaluation of comorbidities in this study detected abnormalities in vital signs, such as elevated blood pressure in 11.2%, and identified conditions that manifest as laboratory test abnormalities, such as hyperglycaemia in 3.3% and hyperlipidaemia in 8.3%. Conclusions Among RA patients, there is a high prevalence of comorbidities and their risk factors. In this multinational sample, variability among countries was wide, not only in prevalence but also in compliance with recommendations for preventing and managing these comorbidities. Systematic measurement of vital signs and laboratory testing detects otherwise unrecognised comorbid conditions.

AB - Background Patients with rheumatoid arthritis (RA) are at increased risk of developing comorbid conditions. Objectives To evaluate the prevalence of comorbidities and compare their management in RA patients from different countries worldwide. Methods Study design: international, cross-sectional. Patients: consecutive RA patients. Data collected: demographics, disease characteristics (activity, severity, treatment), comorbidities (cardiovascular, infections, cancer, gastrointestinal, pulmonary, osteoporosis and psychiatric disorders). Results Of 4586 patients recruited in 17 participating countries, 3920 were analysed (age, 56±13 years; disease duration, 10±9 years (mean±SD); female gender, 82%; DAS28 (Disease Activity Score using 28 joints)-erythrocyte sedimentation rate, 3.7±1.6 (mean±SD); Health Assessment Questionnaire, 1.0±0.7 (mean±SD); past or current methotrexate use, 89%; past or current use of biological agents, 39%. The most frequently associated diseases (past or current) were: depression, 15%; asthma, 6.6%; cardiovascular events (myocardial infarction, stroke), 6%; solid malignancies (excluding basal cell carcinoma), 4.5%; chronic obstructive pulmonary disease, 3.5%. High intercountry variability was observed for both the prevalence of comorbidities and the proportion of subjects complying with recommendations for preventing and managing comorbidities. The systematic evaluation of comorbidities in this study detected abnormalities in vital signs, such as elevated blood pressure in 11.2%, and identified conditions that manifest as laboratory test abnormalities, such as hyperglycaemia in 3.3% and hyperlipidaemia in 8.3%. Conclusions Among RA patients, there is a high prevalence of comorbidities and their risk factors. In this multinational sample, variability among countries was wide, not only in prevalence but also in compliance with recommendations for preventing and managing these comorbidities. Systematic measurement of vital signs and laboratory testing detects otherwise unrecognised comorbid conditions.

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