Ab0334 prevalence and associated factors of multimorbidity in patients with stablished rheumatoid arthritis. data from the crhrear registry

Background Patients with Rheumatoid Arthritis have an increased risk of developing comorbidities that contribute to increased worsened quality, disability and mortality. Knowledge of comorbidity is important when attempting to identify the conditions most associated with the greatest morbidity and mortality. However, comorbidities in RA are often underrecognized despite their impact on disease activity and treatment outcomes. Objectives To evaluate the prevalence of multimorbidity in a cohort of patients with stablished Rheumatoid Arthritis (RA) and the factors associated with such condition. Methods Cross-sectional observational study of a cohort of patients with RA according to the ACR/EULAR 2010 criteria of the CRhreAR registry of the Reina Sofia University Hospital of Córdoba. Multimorbidity was defined, according to the WHO, as the presence of two or more chronic diseases, in addition to RA. Comorbidities included in the Charlson index were collected, in addition to others such as arterial hypertension (HT), dyslipidemia (DL), diabetes mellitus, depression, osteoporosis, interstitial lung disease, and thyroid pathology. Other sociodemographic and disease-related variables were collected. Statistical analysis: descriptive, bivariate analysis and multivariate logistic regression to evaluate variables independently associated with multimorbidity. Results A total of 233 patients were included (mean age 63.6 (13.4) years and 70.4% women). More than 70% were ACPA and RF positive. 99.1% had used any csDMARD and 42.1% any bDMARD. The disease duration was 13.7 years (11.6). 192 patients had at least one comorbidity. 151 (64.8%) had multimorbidity, and the mean age-adjusted Charlson index was 2.9 (2.4). The most frequent morbidity was HT (45.1%) and DL (47.6%), followed by osteoporosis (27.5%) and ILD (16.7%). The most frequent comorbidities included in the Charlson index were cardiovascular disease (14.2%) and cancer (11.2%). Table 1 shows the differences between patients with and without multimorbidity. The multivariate analysis showed that the diagnosis delay of RA [OR 1.31; IC95 (1.1-1.7)], age [OR: 1.2; IC95 (1.1-1.23)] and the number of bDMARDs used since the diagnosis [OR: 2.7; IC95 (1.7-4.3)] were independently associated with multimorbidity, adjusted by sex. Table 1. Differences between patients with multimorbidity and those without multimorbidity. Variable Multimorbidity (n= 151) No multimorbidity (n= 82) p-value Age (years), mean (SD) 68.8 (11.5) 53.8 (10.9) <0.001 Sex (female), n (%) 96 (63.6) 68 (82.9) 0.002 Ever smoked, n (%) 70 (46.3) 29 (35.4) 0.123 Disease duration (years), mean (SD) 14.5 (9.5) 12.1 (14.6) 0.196 Diagnosis delay (years), mean (SD) 3.4 (11.1) 0.9 (1.4) 0.013 Positive Rheumatoid factor, n (%) 112 (74.2) 61 (74.4) 0.971 Rheumatoid factor, mean (SD) 145 (205) 156 (313) 0.805 Positive ACPA, n (%) 110 (72.8) 63 (76.8) 0.558 ACPA, mean (SD) 240 (260) 260 (309) 0.674 Erosions, n (%) 58 (38.4) 32 (39.02) 0.926 Nodules, n (%) 13 (8.6) 11 (13.4) 0.249 DAS28-VSG, mean (SD) 2.7 (1.1) 2.6 (1.1) 0.648 SDAI, mean (SD) 10.5 (10.3) 8.4 (6.9) 0.086 CDAI, mean (SD) 8.7 (7.2) 7.5 (6.3) 0.226 Current csDMARDs, n (%) 99 (65.6) 70 (85.4) 0.002 csDMARDs ever, n (%) 147 (98) 82 (100) 0.292 Current bDMARDs, n (%) 66 (97.3) 26 (31.7) 0.006 bDMARDs ever, n (%) 71 (47.01) 27 (32.9) 0.024 Charlson index, mean (SD) 1.5 (1.7) 0.3 (0.6) <0.001 Age-adjusted Charlson index, mean (SD) 3.9 (2.3) 1.2 (1.3) <0.001 Conclusion These results suggest that the presence of multimorbidity in stablished RA was high (64.8%). The most frequent comorbidities were arterial hypertension, dyslipidemia, interstitial lung disease, and osteoporosis. The diagnosis delay of RA, age and the number of bDMARDs used were independently associated with the presence of multimorbidity. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests None Declared.