Cardiovascular Comorbidities Relate More than Others with Disease Activity in Rheumatoid Arthritis
Identifieur interne : 000344 ( France/Analysis ); précédent : 000343; suivant : 000345Cardiovascular Comorbidities Relate More than Others with Disease Activity in Rheumatoid Arthritis
Auteurs : Gloria Crepaldi [Italie] ; Carlo Alberto Scirè [Italie] ; Greta Carrara [Italie] ; Garifallia Sakellariou [Italie] ; Roberto Caporali [Italie] ; Ihsane Hmamouchi [Maroc] ; Maxime Dougados [France] ; Carlomaurizio Montecucco [Italie]Source :
- PLoS ONE [ 1932-6203 ] ; 2016.
Abstract
To explore the influence of comorbidities on clinical outcomes and disease activity in rheumatoid arthritis (RA).
In patients included in the cross-sectional observational multicenter international study COMORA, demographics, disease characteristics and comorbidities (hypertension, diabetes, hyperlipidemia, renal failure, ischemic heart disease, stroke, cancer, gastro-intestinal ulcers, hepatitis, depression, chronic pulmonary disease, obesity) were collected. Multivariable linear regression models explored the relationship between each comorbidity and disease activity measures: 28-swollen joint count (SJC), 28-tender joint count (TJC), erythrocyte sedimentation rate (ESR), patient’s and physician’s global assessment (PtGA, PhGA), patient reported fatigue and 28-Disease Activity Score (DAS28). Results are expressed as mean difference (MD) adjusted for the main confounders (age, gender, disease characteristics and treatment).
A total of 3,920 patients were included: age (mean ±SD) 56.27 ±13.03 yrs, female 81.65%, disease duration median 7.08 yrs (IQR 2.97–13.27), DAS28 (mean ±SD) 3.74 ± 1.55. Patients with diabetes had more swollen and tender joints and worse PtGA and PhGA (MD +1.06, +0.93, +0.53 and +0.54, respectively). Patients with hyperlipidemia had a lower number of swollen and tender joints, lower ESR and better PtGA and PhGA (MD -0.77, -0.56, -3.56, -0.31 and -0.35, respectively). Patients with history of ischemic heart disease and obese patients had more tender joints (MD +1.27 and +1.07) and higher ESR levels (MD +5.64 and +5.20). DAS28 is influenced exclusively by cardiovascular comorbidities, in particular diabetes, hyperlipidemia, ischemic heart disease and obesity.
Cardiovascular comorbidities relate more than others with disease activity in RA. Diabetes and hyperlipidemia in particular seem associated with higher and lower disease activity respectively influencing almost all considered outcomes, suggesting a special importance of this pattern of comorbidities in disease activity assessment and clinical management.
Url:
DOI: 10.1371/journal.pone.0146991
PubMed: 26757209
PubMed Central: 4710534
Affiliations:
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last="Sakellariou">Garifallia Sakellariou</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy</addr-line></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia</wicri:regionArea><wicri:noRegion>Pavia</wicri:noRegion></affiliation></author><author><name sortKey="Caporali, Roberto" sort="Caporali, Roberto" uniqKey="Caporali R" first="Roberto" last="Caporali">Roberto Caporali</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy</addr-line></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia</wicri:regionArea><wicri:noRegion>Pavia</wicri:noRegion></affiliation></author><author><name sortKey="Hmamouchi, Ihsane" sort="Hmamouchi, Ihsane" uniqKey="Hmamouchi I" first="Ihsane" last="Hmamouchi">Ihsane Hmamouchi</name><affiliation wicri:level="3"><nlm:aff id="aff003"><addr-line>Mohammed V Souissi University, Faculty of Medicine, Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Rabat, Morocco</addr-line></nlm:aff><country xml:lang="fr">Maroc</country><wicri:regionArea>Mohammed V Souissi University, Faculty of Medicine, Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Rabat</wicri:regionArea><placeName><settlement type="city">Rabat</settlement><region nuts="2">Rabat-Salé-Kénitra</region></placeName></affiliation></author><author><name sortKey="Dougados, Maxime" sort="Dougados, Maxime" uniqKey="Dougados M" first="Maxime" last="Dougados">Maxime Dougados</name><affiliation wicri:level="3"><nlm:aff id="aff004"><addr-line>Rheumatology B Department, Hospital Cochin, Medicine Faculty, Paris-Descartes University, Paris, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Rheumatology B Department, Hospital Cochin, Medicine Faculty, Paris-Descartes University, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Montecucco, Carlomaurizio" sort="Montecucco, Carlomaurizio" uniqKey="Montecucco C" first="Carlomaurizio" last="Montecucco">Carlomaurizio Montecucco</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy</addr-line></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia</wicri:regionArea><wicri:noRegion>Pavia</wicri:noRegion></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Objectives</title><p>To explore the influence of comorbidities on clinical outcomes and disease activity in rheumatoid arthritis (RA).</p></sec><sec id="sec002"><title>Methods</title><p>In patients included in the cross-sectional observational multicenter international study COMORA, demographics, disease characteristics and comorbidities (hypertension, diabetes, hyperlipidemia, renal failure, ischemic heart disease, stroke, cancer, gastro-intestinal ulcers, hepatitis, depression, chronic pulmonary disease, obesity) were collected. Multivariable linear regression models explored the relationship between each comorbidity and disease activity measures: 28-swollen joint count (SJC), 28-tender joint count (TJC), erythrocyte sedimentation rate (ESR), patient’s and physician’s global assessment (PtGA, PhGA), patient reported fatigue and 28-Disease Activity Score (DAS28). Results are expressed as mean difference (MD) adjusted for the main confounders (age, gender, disease characteristics and treatment).</p></sec><sec id="sec003"><title>Results</title><p>A total of 3,920 patients were included: age (mean ±SD) 56.27 ±13.03 yrs, female 81.65%, disease duration median 7.08 yrs (IQR 2.97–13.27), DAS28 (mean ±SD) 3.74 ± 1.55. Patients with diabetes had more swollen and tender joints and worse PtGA and PhGA (MD +1.06, +0.93, +0.53 and +0.54, respectively). Patients with hyperlipidemia had a lower number of swollen and tender joints, lower ESR and better PtGA and PhGA (MD -0.77, -0.56, -3.56, -0.31 and -0.35, respectively). Patients with history of ischemic heart disease and obese patients had more tender joints (MD +1.27 and +1.07) and higher ESR levels (MD +5.64 and +5.20). DAS28 is influenced exclusively by cardiovascular comorbidities, in particular diabetes, hyperlipidemia, ischemic heart disease and obesity.</p></sec><sec id="sec004"><title>Conclusions</title><p>Cardiovascular comorbidities relate more than others with disease activity in RA. Diabetes and hyperlipidemia in particular seem associated with higher and lower disease activity respectively influencing almost all considered outcomes, suggesting a special importance of this pattern of comorbidities in disease activity assessment and clinical management.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Smolen, Js" uniqKey="Smolen J">JS Smolen</name></author><author><name sortKey="Aletaha, D" uniqKey="Aletaha D">D Aletaha</name></author><author><name sortKey="Bijlsma, Jwj" uniqKey="Bijlsma J">JWJ Bijlsma</name></author><author><name sortKey="Breedveld, Fc" uniqKey="Breedveld F">FC Breedveld</name></author><author><name sortKey="Boumpas, D" uniqKey="Boumpas D">D Boumpas</name></author><author><name sortKey="Burmester, G" uniqKey="Burmester G">G Burmester</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Schoels, M" uniqKey="Schoels M">M Schoels</name></author><author><name 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uniqKey="Andersson M">ML Andersson</name></author><author><name sortKey="Hafstrom, I" uniqKey="Hafstrom I">I Hafström</name></author><author><name sortKey="Group For The, Bs" uniqKey="Group For The B">BS Group for the</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kaysen, Ga" uniqKey="Kaysen G">GA Kaysen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Putrik, P" uniqKey="Putrik P">P Putrik</name></author><author><name sortKey="Ramiro, S" uniqKey="Ramiro S">S Ramiro</name></author><author><name sortKey="Hifinger, M" uniqKey="Hifinger M">M Hifinger</name></author><author><name sortKey="Keszei, Ap" uniqKey="Keszei A">AP Keszei</name></author><author><name sortKey="Hmamouchi, I" uniqKey="Hmamouchi I">I Hmamouchi</name></author><author><name sortKey="Dougados, M" uniqKey="Dougados M">M Dougados</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>France</li><li>Italie</li><li>Maroc</li></country><region><li>Lombardie</li><li>Rabat-Salé-Kénitra</li><li>Île-de-France</li></region><settlement><li>Milan</li><li>Paris</li><li>Rabat</li></settlement></list><tree><country name="Italie"><noRegion><name sortKey="Crepaldi, Gloria" sort="Crepaldi, Gloria" uniqKey="Crepaldi G" first="Gloria" last="Crepaldi">Gloria Crepaldi</name></noRegion><name sortKey="Caporali, Roberto" sort="Caporali, Roberto" uniqKey="Caporali R" first="Roberto" last="Caporali">Roberto Caporali</name><name sortKey="Carrara, Greta" sort="Carrara, Greta" uniqKey="Carrara G" first="Greta" last="Carrara">Greta Carrara</name><name sortKey="Montecucco, Carlomaurizio" sort="Montecucco, Carlomaurizio" uniqKey="Montecucco C" first="Carlomaurizio" last="Montecucco">Carlomaurizio Montecucco</name><name sortKey="Sakellariou, Garifallia" sort="Sakellariou, Garifallia" uniqKey="Sakellariou G" first="Garifallia" last="Sakellariou">Garifallia Sakellariou</name><name sortKey="Scire, Carlo Alberto" sort="Scire, Carlo Alberto" uniqKey="Scire C" first="Carlo Alberto" last="Scirè">Carlo Alberto Scirè</name></country><country name="Maroc"><region name="Rabat-Salé-Kénitra"><name sortKey="Hmamouchi, Ihsane" sort="Hmamouchi, Ihsane" uniqKey="Hmamouchi I" first="Ihsane" last="Hmamouchi">Ihsane Hmamouchi</name></region></country><country name="France"><region name="Île-de-France"><name sortKey="Dougados, Maxime" sort="Dougados, Maxime" uniqKey="Dougados M" first="Maxime" last="Dougados">Maxime Dougados</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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