Comorbidity in rheumatoid arthritis of early onset. Effects on outcome parameters

被引：15
作者：
Westhoff G. [1 ,2 ]
Weber C. [1 ]
Zink A. [1 ]
机构：
[1] Forschungsbereich Rheumatologie, Deutsches Rheuma-Forschungszentrum Berlin (DRFZ), Berlin
[2] Forschungsbereich Rheumatologie, Deutsches Rheuma-Forschungszentrum Berlin (DRFZ), 10117 Berlin
来源：
Zeitschrift für Rheumatologie | 2006年 / 65卷 / 6期
关键词：
Comorbidity; Disease activity; Functional capacity; Outcome; Rheumatoid arthritis;
D O I：
10.1007/s00393-006-0102-z
中图分类号：
学科分类号：
摘要：
Three-year follow-up data of 1,032 patients with recent onset rheumatoid arthritis (RA) were analyzed regarding the frequency of 21 common comorbid chronic conditions and their impact on health outcome (i.e., pain, functional capacity, disease activity, and radiographic joint damage). Multivariate logistic regression analyses were used to calculate age- and gender-adjusted odds ratios for each chronic condition on severe functional capacity (<60% of full function). Comorbidity was already common at the onset of RA, with 72% of the patients having at least one comorbid condition and almost 50% having at least two. Common comorbidities were associated with significantly worse baseline measures in at least three of seven investigated outcome parameters. The more of these conditions patients had, the worse their 3-year outcome. Functional capacity was most sensitive to comorbid conditions. In logistic regression, obesity, hypercholesterolemia, type II diabetes, and osteoporosis resulted in a twofold risk of severe functional limitation (<60% of full function), independent of each other and of age and gender. The impact of comorbidity on measures of disease severity should be considered when used to compare outcome parameters of different RA samples. © Springer Medizin Verlag 2006.
引用
收藏
页码：487 / 496
页数：9
相关论文
共 30 条
  • [1] Arnett F.C., Edworthy S.M., Bloch D.A., Et al., The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis, Arthritis Rheum, 31, pp. 315-324, (1988)
  • [2] Baldini C., Delle S.A., Bombardieri S., From clinical trials to the bedside: How can we treat patients with rheumatoid arthritis and concurrent morbidities who are generally excluded from randomised controlled clinical trials?, Clin Exp Rheumatol, 23, pp. 893-904, (2005)
  • [3] Berkanovic E., Hurwicz M.L., Rheumatoid arthritis and comorbidity, J Rheumatol, 17, pp. 888-892, (1990)
  • [4] DeMaria A.N., Relative risk of cardiovascular events in patients with rheumatoid arthritis, Am J Cardiol, 89, (2002)
  • [5] Doran M.F., Crowson C.S., Pond G.R., Et al., Frequency of infection in patients with rheumatoid arthritis compared with controls - A population-based study, Arthritis Rheum, 46, pp. 2287-2293, (2002)
  • [6] Franklin J., Lunt M., Bunn D., Et al., Incidence of lymphoma in a large primary care derived cohort of cases of inflammatory polyarthritis, Ann Rheum Dis, 65, pp. 617-622, (2006)
  • [7] Gabriel S.E., Crowson C.S., O'Fallon W.M., Comorbidity in arthritis, J Rheumatol, 26, pp. 2475-2479, (1999)
  • [8] Goodson N., Coronary artery disease and rheumatoid arthritis, Curr Opin Rheumatol, 14, pp. 115-120, (2002)
  • [9] Hirayama T., Danks L., Sabokbar A., Athanasou N.A., Osteoclast formation and activity in the pathogenesis of osteoporosis in rheumatoid arthritis, Rheumatology, 41, pp. 1232-1239, (2002)
  • [10] Jochems C., Islander U., Erlandsson M., Et al., Osteoporosis in experimental postmenopausal polyarthritis: The relative contributions of estrogen deficiency and inflammation, Arthritis Res Ther, 7, (2005)
123