Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring in clinical practice: the spanish cohort of the COMORA study.
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Balsa Alejandro, Lojo-Oliveira Leticia, Alperi-López Mercedes, García-Manrique María, Ordóñez-Cañizares Carmen, Pérez Lorena, Ruiz-Esquide Virginia, Corrales Alfonso, Narváez Javier, Rey-Rey José, Rodríguez-Lozano Carlos, Ojeda Soledad, Muñoz-Fernández Santiago, Nolla Joan M, García-Torrón José, Gamero Fernando, García-Vicuña Rosario, Hernández-Cruz Blanca, Campos José, Rosas José, García-Llorente José Francisco, Gómez-Centeno Antonio, Cáliz Rafael, Sanmartí Raimon, Bermúdez Alberto, Abasolo-Alcázar Lydia, Fernández-Nebro Antonio, Rodríguez-Rodríguez Luis, Marras Carlos, González-Gay Miguel Ángel, Hmamouchi Ihsane, Martín-Mola Emilio
Аннотация
METHODS: This is a national sub-analysis of the COMORA study. We studied the demographics and disease characteristics of 200 adults patients diagnosed with RA (1987 ACR), and routine practices for screening and preventing the following selected comorbidities: cardiovascular, infections, cancer, gastrointestinal, pulmonary, osteoporosis and depression.
RESULTS: Patients had a mean age of 58 years and a mean RA duration of 10 years. Mean DAS28 score was 3.3 and approximately 25% of patients were in remission (DAS28 <2.6). Forty-four (22%) patients had ≥1 comorbidity, the most frequent being depression (27%) and obesity (26%). A history of myocardial infarction or stroke was observed in 5% and 1% of patients, respectively, and any solid tumor in 6%. Having a Framingham Risk Score >20% (51%), hypercholesterolemia (46%) or hypertension (41%) and smoking (25%) were the most common CV risk factors. For prostate, colon and skin cancers, only 9%, 10% and 18% of patients, respectively, were optimally monitored. Infections were also inadequately managed, with 7% and 17% of patients vaccinated against influenza and pneumococcal, respectively, as was osteoporosis, with 47% of patients supplemented with vitamin D and 56% with a bone densitometry performed.
CONCLUSIONS: In Spain, the prevalence of comorbidities and CV risk factors in RA patients with established and advanced disease is relatively high, and their management in clinical daily practice remains suboptimal.