AB0400 High prevalence of comorbidities in patients with rheumatoid arthritis in south africa
Authors: S. Botha-Scheepers, A.G.A. Mohammed, A. Gcelu, B. Hodkinson
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Patients with rheumatoid arthritis (RA) are at increased risk to develop comorbidities. Data on the prevalence of comorbidities in RA patients in South-Africa is lacking.<sup>1</sup> Poorly controlled joint inflammation, common use of glucocosteroids and nonsteroidal anti-inflammatory drugs, a high prevalence of smoking and obesity, together with a high burden of infectious diseases may be important risk factors for comorbidities in this population. <h3>Objectives</h3> To assess the prevalence of comorbidities in RA patients in Cape Town, South-Africa and the association with disease activity and DMARD use using the METEOR (Measurement of Efficacy of Treatment in the 'Era of Outcome' in Rheumatology) database. <h3>Methods</h3> This is an ongoing cross-sectional study. Data from 109 RA patients from regular clinic visits at Groote Schuur Hospital in Cape Town, South Africa have been entered in the Meteor database (from December 2016). The Meteor database is a free online tool that was developed to improve the management of RA patients by helping rheumatologists to register, monitor and tightly control disease activity. The tool is currently widely used in other countries, but has it has not yet been described in any African countries. Information on the following parameters were reported: demographics, disease duration, disease activity (CDAI), current DMARDs used and comorbidities. <h3>Results</h3> The mean age (SD) was 57.6 (14.7) years, disease duration (SD) 14.1 (14.6) years, female gender 86.7%, RF positive 85.1% and ACPA positive 80.4%. The average (SD) CDAI was 13.1 (9.8) and 49.3% were smokers. Current DMARDs used was Methotrexate (72%), Sulphasalazine (29%), Chloroquine (67%), Low dose corticosteroids (47%), Leflunomide (11%), Etanacept (1%), but no other biological agents (0%). At least one comorbidity was present in 69% of the patients, two in 40%, three in 26%, four in 13% and five in 2% of the patients. The most frequently observed comorbid diseases were hypertension (45.5%), tuberculosis (TB) (11.1%), Diabetes Mellitis Type 2 (10.9%) and osteoarthritis (10.9%). Other diseases included hypercholesterolemia (7.1%), gastro-oesophageal reflux disease/peptic ulcer (6.1%), COPD/emphysema (6.1%), HIV (4.0%), hypothyroidism (4.0%), ischaemic heart disease (3.0%), liver disease (3.0%), DVT/pulmonary embolism (3.0%), malignancies (3.0%), asthma (2.0%), discoid lupus erythematosus (2.0%), interstitial lung disease (1.0%), anaemia (1.0%), rheumatic heart disease (1.0%), cerebrovascular accident (1.0%) and depression (1.0%). <h3>Conclusions</h3> This study shows a high prevalence of comorbidities among indigent patients with RA in South Africa. In particular, hypertension, TB and osteoarthritis were very common. More patients will be included in this study in the next few months. Furthermore, we will assess the association between comorbidities, disease activity and DMARD use. The METEOR tool offers the unique opportunity to study daily practice care as well as research questions in real life setting in a South African clinic. This study will provide information that is necessary to address the burden of comorbidities in patients with RA in South Africa. <h3>Reference</h3> [1] Dougados M, Soubrier M, et al. Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA). Ann Rheum Dis2014;73:62–8. <h3>Disclosure of Interest</h3> None declared