AB1345 COMORBIDITY PROFILES IN INFLAMMATORY RHEUMATIC DISEASES: AN ANALYTICAL PERSPECTIVE
Authors: R. Kocak Ulucaköy, H. Babaoglu, E. Kayacan Erdoğan, K. Orhan, E. Atalar, S. C. Güven, H. E. Konak, B. Özdemir Ulusoy, P. Akyüz Dağli, Ö. Karakaş, H. Apaydin, M. A. Eksin, B. Polat, S. Esmer, İ. Dogan, Y. Maraş, A. Omma, O. Küçükşahin, S. Erten, B. Armagan
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Inflammatory rheumatic diseases (IRDs) manifest as complex, chronic conditions that are often associated with multiple comorbidities. These comorbidities can significantly impact patient prognosis, complicate disease management and potentially limit therapeutic options. Recent guidelines highlights the importance of identifying and managing these comorbidities to improve patient care in IRDs. Managing comorbidies now seen as important as management of primary IRD. <h3>Objectives:</h3> This study aims to systematically assess the prevalence and nature of comorbidities in patients with IRDs at our clinic. <h3>Methods:</h3> This is a retrospective single-center study. IRD were classified as rheumatoid arthritis (RA), spondyloarthritis (SpA), connective tissue diseases (CTD), autoinflammatory diseases (AID), Behçet's disease (BD), large vessel vasculitis (LVV), small vessel vasculitis (SVV) and crystal arthritis (CA). Demographic characteristics and comorbidities were obtained through electronic health records. A descriptive analysis of all patients was performed. Numerical data were presented as mean. Categorical variables were presented as numbers and percentages. Lineer regression analysis was done to evaluate the association between total comorbidity count and each IRD group with the adjustment of age and sex. <h3>Results:</h3> The study included 10417 patients with IRD. The distribution of the patients is shown in Table 1. The mean age (SD) was 50.9 (14.5) years, with a female predominance (66.8%). The five most common comorbidities were hypertension (35%), obesity (29%), diabetes mellitus (14%), hyperlipidaemia (12%) and osteoporosis (9.2%). The median (min-max) number of comorbidities was 1.3 (0-9). Notably, patients with crystal arthritis had the highest comorbidity rates, particularly for hypertension (65.7%) and obesity (47.4%). Chronic kidney disease and asthma were more common in patients with small vessel vasculitis. The frequency of comorbidities in IRD groups were shown in Figure 1. Linear regression analysis revealed significant associations between the total number of comorbidities and Crystal Arthritis, Large Vessel Vasculitis and Small Vessel Vasculitis, after adjustment for age and sex (Table 2). <h3>Conclusion:</h3> After adjustment for age and sex, the study found a significant correlation between the total number of comorbidities and the presence of LVV, SVV and CA. This is in line with existing evidence that recognises crystal arthritis as a consequence of the metabolic syndrome. Similarly, the life-threatening nature and aggressive immunosuppressive treatment of vasculitis may contribute to increased comorbidity rates. In light of these findings, Awareness of comorbidity should be increased, given the association of comorbidity with all IRDs, especially SVV, LCC and Crystal arthritis, it is imperative to conduct a thorough and ongoing assessment of comorbidities in patients with IRD, beginning at the time of diagnosis, to optimise patient outcomes and disease management strategies. <h3>REFERENCES:</h3> [1] Rajesh D, Jannat-Khah D, Do H, Levine J, Barbhaiya M, Mandl L, et al. Comorbidity Burden as Scored Using the Rheumatic Disease Comorbidity Index (RDCI) Is Associated with Varying Treatment Patterns in Patients with Inflam- matory Arthritis – a Study Using the EHR-Derived Rheumatic and Arthritis Disease Information Registry (RADIR). Arthritis Rheumatol. 2021;73(10)). [2] Smolen JS, Landewé RBM, Bijlsma JWJ, Burmester GR, Dougados M, Kersch- baumer A, et al. EULAR recommendations for the management of rheuma- toid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis. 2020;79(6):685–99. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>