Comorbidities Start Early in Rheumatoid Arthritis Save

A Northern Sweden early rheumatoid arthritis (RA) cohort of 950 patients was enrolled starting in 1995. A validated questionnaire at RA onset (T0) and after 5 years (T5) after enrollment. Currently, 726 of these have had RA for ≥5 years.

One or more comorbidities were seen in 53.2% of the RA at onset (enrollment). These included hypertension (27.3%), COPD (13.9%), diabetes (8%), 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%).

The risk of new comorbidity after 5 years was predicted by age at disease onset, raised ESR, prior glucocorticoids, extra-articular, DAS28 at 24 months, previous smoking and being male. Treatment with biologics (p 0.05) reduced the risk.

There was substantial co-morbidity among early RA patients already at disease onset, with considerable new co-morbidity being added during the first five years. Measures of disease activity were associated with the occurrence of a new co-morbidity indicating that the inflammation a primary driver of comorbidity.