Multimorbidity Impairs Responses in Rheumatoid Arthritis Save

A retrospective analysis of the ACR RISE registry shows that multimorbidity is not only common in patients with active rheumatoid arthritis (RA), but also impacts treatment choices and outcomes.

Analysis of active RA patients in the Rheumatology Informatics System for Effectiveness (RISE) registry identified comorbidities. Multimorbidity was measured using a medication-based index of chronic disease and correlated with new DMARD starts and the odds of achieving low disease activity or remission. RA status and outcomes were assessed using RAPID3 or CDAI measures.

Among 15,626 (RAPID3) and 5,733 (CDAI) patients with active RA, 1,558 (RAPID3) and 834 (CDAI) initiated a new DMARD and had follow-up disease activity measures.

Patients were middle aged, Caucasian predominant, taking medications from 6-7 RxRisk categories.

While multimorbidity was not associated with new DMARD initiation in active RA, a greater level of multimorbidity was associated with a 5-6% lower odds of achieving treatment targets (per 1-unit RxRisk OR 0.95 RAPID3 cohort; OR 0.94 CDAI cohort).

Those with the highest burden of multimorbidity had the lowest odds of achieving target RA disease activity (OR 0.54 RAPID3 cohort; OR 0.65 CDAI cohort).

These real world findings suggest a significant impact of multimorbidity on treatment response.  Comorbidity management remains an unmet need in the treatment plans of most RA patients.