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
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
  • [11] Kroot E.J., Van Gestel A.M., Swinkels H.L., Et al., Chronic comorbidity in patients with early rheumatoid arthritis: A descriptive study, J Rheumatol, 28, pp. 1511-1517, (2001)
  • [12] Maradit-Kremers H., Nicola P.J., Crowson C.S., Et al., Cardiovascular death in rheumatoid arthritis: A population-based study, Arthritis Rheum, 52, pp. 722-732, (2005)
  • [13] Mercado F.B., Marshall R.I., Bartold P.M., Interrelationships between rheumatoid arthritis and periodontal disease. A review, J Clin Periodontol, 30, pp. 761-772, (2003)
  • [14] Navarro-Cano G., Del R.I., Pogosian S., Et al., Association of mortality with disease severity in rheumatoid arthritis, independent of comorbidity, Arthritis Rheum, 48, pp. 2425-2433, (2003)
  • [15] Prevoo M.L., T Hof M.A., Kuper H.H., Et al., Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis, Arthritis Rheum, 38, pp. 44-48, (1995)
  • [16] Raspe H.H., Hagedorn U., Kohlmann T., Mattussek S., Der Funktionsfragebogen Hannover (FFbH): Ein Instrument zur Funktionsdiagnostik bei polyartikula&die
  • [17] ren Gelenkerkrankungen, Wohnortnahe Betreuung Rheumakranker. Ergebnisse Sozialwissenschaftlicher Evaluation Eines Modellversuchs, pp. 164-182, (1990)
  • [18] Rau R., Wassenberg S., Herborn G., Et al., A new method of scoring radiographic change in rheumatoid arthritis, J Rheumatol, 25, pp. 2094-2107, (1998)
  • [19] Roldan J.F., Del R.I., Escalante A., Loss of cortical bone from the metacarpal diaphysis in patients with rheumatoid arthritis: Independent effects of systemic inflammation and glucocorticoids, J Rheumatol, 33, pp. 508-516, (2006)
  • [20] Seriolo B., Accardo S., Fasciolo D., Et al., Lipoproteins, anticardiolipin antibodies and thrombotic events in rheumatoid arthritis, Clin Exp Rheumatol, 14, pp. 593-599, (1996)