High prevalence of gallstone disease in rheumatoid arthritis: A new comorbidity related to dyslipidemia? / Alta prevalencia de litiasis biliar en la artritis reumatoide: ¿una nueva comorbilidad relacionada con la dislipidemia?

Objective: To assess the prevalence of gallstone disease and identify associated risk factors in rheumatoid arthritis (RA) patients compared to the general population. Methods: Eighty-four women with rheumatoid arthritis were included in the study. Each patient was assessed via a structured interview, physical examination, abdominal ultrasound and blood test including lipid profile. The prevalence of gallstone disease in rheumatoid arthritis was compared with data from a study of the Spanish population matched by age groups. Results: Twenty-eight of the 84 women had gallstone disease (33.3%). RA women with and without gallstone disease were similar in most of the variables assessed, except for older age and menopausal status in the former. A greater prevalence of gallstone disease was seen in rheumatoid arthritis patients compared to the general population of the same age; however, the differences were significant only in women aged 60 or older (45.5% versus 23.1% respectively, P-value .008). The age-adjusted OR of developing gallstone disease in RA women compared with general population women was 2,3 (95% CI: 1.3-4.1). A significantly higher HDL3-c subfraction and higher apoA-I/HDL and HDL3-c/TC ratios were observed in patients with gallstone disease. Conclusion: Women with rheumatoid arthritis may have a predisposition to gallstones that can manifest in middle or older age compared with women in the general population. This situation could be related to chronic inflammation and HDL metabolism

Objetivo: Evaluar la prevalencia de litiasis biliar e identificar los factores de riesgo asociados en pacientes con artritis reumatoide (AR) en comparación con la población general. Métodos: Ochenta y cuatro mujeres con AR fueron incluidas en el estudio. Cada paciente fue evaluada a través de una entrevista estructurada, un examen físico, una ecografía abdominal y un análisis de sangre que incluía el perfil lipídico. La prevalencia de litiasis biliar en AR se comparó con los datos de un estudio de la población española emparejada por grupos de edad. Resultados: Veintiocho de las 84 mujeres tenían litiasis biliar (33,3%). Las pacientes con y sin colelitiasis fueron similares en la mayoría de las variables evaluadas, a excepción de la edad más avanzada y mayor prevalencia de estado menopáusico en las pacientes con AR. Las pacientes con AR presentaban una mayor prevalencia de litiasis biliar en comparación con la población general de la misma edad; sin embargo, estas diferencias solo fueron significativas en mujeres de 60 años o más (45,5% vs. 23,1% respectivamente, p-valor 0,008). La OR ajustada por edad de presentar litiasis biliar en mujeres con AR respecto a mujeres de la población general fue de 2,3 (IC del 95%: 1,3-4,1). Se observó una subfracción de c-HDL3 significativamente más alta y una relación mayor de apoA-I/HDL y c-HDL3/TC en las pacientes con litiasis biliar. Conclusión: Las mujeres con AR pueden tener una mayor predisposición a la presencia de litiasis biliar en comparación con las mujeres en la población general, sobre todo en edades más avanzadas. Esta situación podría estar relacionada con la inflamación crónica y el metabolismo de las HDL

High prevalence of gallstone disease in rheumatoid arthritis: A new comorbidity related to dyslipidemia?

OBJECTIVE: To assess the prevalence of gallstone disease and identify associated risk factors in rheumatoid arthritis (RA) patients compared to the general population. METHODS: Eighty-four women with rheumatoid arthritis were included in the study. Each patient was assessed via a structured interview, physical examination, abdominal ultrasound and blood test including lipid profile. The prevalence of gallstone disease in rheumatoid arthritis was compared with data from a study of the Spanish population matched by age groups. RESULTS: Twenty-eight of the 84 women had gallstone disease (33.3%). RA women with and without gallstone disease were similar in most of the variables assessed, except for older age and menopausal status in the former. A greater prevalence of gallstone disease was seen in rheumatoid arthritis patients compared to the general population of the same age; however, the differences were significant only in women aged 60 or older (45.5% versus 23.1% respectively, P-value .008). The age-adjusted OR of developing gallstone disease in RA women compared with general population women was 2,3 (95% CI: 1.3-4.1). A significantly higher HDL3-c subfraction and higher apoA-I/HDL and HDL3-c/TC ratios were observed in patients with gallstone disease. CONCLUSION: Women with rheumatoid arthritis may have a predisposition to gallstones that can manifest in middle or older age compared with women in the general population. This situation could be related to chronic inflammation and HDL metabolism.

RENACER study: Assessment of 12-month efficacy and safety of 168 certolizumab PEGol rheumatoid arthritis-treated patients from a Spanish multicenter national database.

OBJECTIVE: To assess effectiveness and safety of certolizumab PEGol (CZP) in rheumatoid arthritis (RA) patients after 12 months of treatment and to detect predictors of response. METHODS: Observational longitudinal prospective study of RA patients from 35 sites in Spain. Variables (baseline, 3- and 12-month assessment): sociodemographics, previous Disease Modifying Anti-Rheumatic Drug (DMARD) and previous Biological Therapies (BT) use; TJC, SJC, ESR, CRP, DAS28, SDAI. Response variables: TJC, SJC, CRP, ESR, and steroids dose reductions, EULAR Moderate/Good Response, SDAI response and remission, DAS28 remission. Safety variables: discontinuation due to side-effects. Descriptive, comparative and Logistic regression analyses were performed. RESULTS: We included 168 patients: 79.2% women, mean age 54.5 years (±13.2 SD), mean disease duration 7.5 years (±7.3 SD). Mean number of prior DMARD: 1.4 (±1.2 SD), mean number of prior BT was 0.8 (±1.1). Mean time on CZP was 9.8 months (±3.4 SD). A total of 71.4% were receiving CZP at 12-month assessment. Baseline predictors of response: lower prior number DMARD; low number prior BT; higher CRP, ESR, TJC, SJC, DAS28 and SDAI (p < 0.05) scores. A 25/46.4% Moderate/Good Response, a 20% SDAI remission, and a 44% DAS28 remission were observed. We observed 48 discontinuations (28.6%), 31 due to partial or complete ineffectiveness, and 17 due to side-effects. CONCLUSIONS: CZP showed benefit in severe RA patients, with significant reduction of all effectiveness parameters, despite the high prevalence of previous BT exposure in our series. We found CRP, ESR, prior DMARD/BT number, TJC, SJC, DAS28, and SDAI as baseline predictors of response. CZP was mostly well tolerated.