The total and disease-specific direct medical costs for patients with RA is substantial. Among bDMARD users, the cost of RA care is more than half of all direct medical costs.

Objective To elucidate how postdiagnosis multimorbidity and lifestyle changes contribute to the excess mortality of rheumatoid arthritis (RA). Methods We performed a matched cohort study among women in the Nurses’ Health Study (1976–2018). We identified women with incident RA and matched each by age and year to 10 non‐RA comparators at the RA diagnosis index date. Specific causes of death were ascertained via death certificates and medical record review. Lifestyle and morbidity factors were reported biennially; 61 chronic conditions were combined into the Multimorbidity Weighted Index (MWI). After adjusting for baseline confounders, we used inverse probability weighting analysis to examine the mediating influence of postindex MWI scores and lifestyle factors on total, cardiovascular, and respiratory mortality, comparing women with RA to their matched comparators. Results We identified 1,007 patients with incident RA and matched them to 10,070 non‐RA comparators. After adjusting for preindex confounders, we found that hazard ratios (HRs) and 95% confidence intervals (95% CIs) were higher for total mortality (HR 1.46 [95% CI 1.32, 1.62]), as well as cardiovascular (HR 1.54 [95% CI 1.22, 1.94]) and respiratory (HR 2.75 [95% CI 2.05, 3.71]) mortality in patients with RA compared to non‐RA comparators. Adjusting for postindex lifestyle factors (physical activity, body mass index, diet, smoking) attenuated but did not substantially account for this excess RA mortality. After additional adjustment for postindex MWI scores, patients with RA had HRs of 1.18 (95% CI 1.05, 1.32) for total, 1.19 (95% CI 0.94, 1.51) for cardiovascular, and 1.93 (95% CI 1.42, 2.62) for respiratory mortality. Conclusion We found that MWI scores substantially accounted for the excess total and cardiovascular mortality among women with RA. This finding underscores the importance of monitoring for the total disease burden as a whole in monitoring patients with RA.

Our findings suggest that higher intake of fish may be associated with lower disease activity in RA patients.

In this prospective cohort study, RA was associated with increased risk for incident COPD, independent of lifestyle confounders and mediators after diagnosis, including smoking.

We found that the HBV reactivation rate in inflammatory arthritis patients receiving DMARDs was low in resolved patients and moderate in patients with chronic HBV infection. Further, lower rates were observed in patients with chronic HBV infection who were using antiviral prophylaxis.

Background: The gut-selective nature of vedolizumab has raised questions regarding increased joint pain or arthralgias with its use in IBD patients. Since arthralgias are seldom coded and thus difficult to study, few studies have examined the comparative risk of arthralgias between vedolizumab and tumor necrosis factor inhibitor (TNFi). Objectives: To evaluate the application of natural language processing (NLP) to identify arthralgias in the clinical notes, and to compare the risk of arthralgia between vedolizumab and TNFi in IBD. Methods: We performed a retrospective study using a validated electronic medical record (EMR) based IBD cohort from 2 large tertiary care centers. The index date was the first date of vedolizumab or TNFi prescription. Baseline covariates were assessed 1-year period before the index date; patients were followed 1-year after the index date. The primary outcome was arthralgias defined using NLP. Using inverse probability of treatment weight to balance the cohorts, we then constructed Cox regression models to calculate the hazard ratio (HR) for arthralgia in the vedolizumab vs TNFi groups. Results: We studied 367 patients on vedolizumab and 1,218 on TNFi IBD patients. Patients on vedolizumab were older, mean age 41.2 vs. 34.9 years, and had more prevalent use of immunomodulators, 52.3% vs. 31.9%, than TNFi users. Our data did not observe a significant increased risk of arthralgias in the vedolizumab group compared with TNFi (HR, 1.20; 95%CI, 0.97–1.49). Conclusions: In this large observational study, we did not find a significant increased risk of arthralgias associated with vedolizumab use compared with TNFi.

Despite elevated CVD risk, SLE patients receive less lipid testing and statin prescriptions than age- and sex-matched DM and general Medicaid patients and this gap should be a target for improvement. This article is protected by copyright. All rights reserved.

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