MULTIMORBIDITY BURDEN in RHEUMATOID ARTHRITIS

ABSTRACT

Background: Multimorbidity in patients with rheumatoid arthritis (RA) has been described as the coexistence of two or more chronic diseases and is the most common cause of death in this population. Objectives: To describe the prevalence of multimorbidity and mortality trends in a well-characterized cohort of patients with RA. Methods: A retrospective cohort study of patients with RA (1987 ACR criteria) was conducted. Each patient was evaluated and followed by a rheuma-tologist in a single outpatient private center in Bogotá, Colombia, from 2014 to 2021. Categorical variables were expressed in frequency and percentage and quantitative variables in mean and standard deviation or median with interquartile range, depending on the distribution of the data. Statistical package SPSS 25. Results: A total of 783 patients were included. 11% of patients with RA present multimorbidity. Baseline characteristics were as follows female gender 81.6%, mean age 51.8±11 years, mean disease duration 8 (IQR 3-15) years, RF positive 80.1%, ACPA positive 58.2%, and erosions 24.9%. Most patients have received glucocorticoids (89.8%), and conventional synthetic DMARDs (97.8%), being prednisone and methotrexate the most frequently prescribed. Hypertension was prevalent in 27.7%, osteoporosis 19.3%, malignancies in 5.5% and principal infection was urinary infection 14.3%. Polyautoimmunity was present in 5.7% most frequently Autoimmune thyroid diseases 10.6% and Sjögren syndrome 9%. After a median of 73 months of follow-up, the mortality rate was 1% of the entire cohort, being cardiovascular disease and COVID-19 infection the main causes. Conclusion: Patients with RA have an important multimorbidity burden and this increased risk of adverse outcomes and mortality.