Increased risk of rheumatoid arthritis in patients with migraine: a population-based, propensity score-matched cohort study

Abstract

Previous cross-sectional studies have suggested an association between migraine and rheumatoid arthritis (RA), but no longitudinal study has been performed to evaluate the temporal relationship between the two conditions. The purpose of the present population-based, propensity score-matched cohort study was to investigate whether migraineurs are at a higher risk of developing RA. A total of 58,749 subjects aged between 20 and 90 years with at least two ambulatory visits with a diagnosis of migraine were recruited in the migraine group. We fit a logistic regression model that included age, sex, comorbid conditions, and socioeconomic status as covariates to compute the propensity score. The non-migraine group consisted of 58,749 propensity score-matched, randomly sampled subjects without migraine. The RA-free survival curves were generated using the Kaplan-Meier method. Stratified Cox proportional hazard regression was used to estimate the effect of migraine on the risk of RA. During follow-up, 461 subjects in the migraine group and 220 in the non-migraine group developed RA. The incidence rate of RA was 3.18 (95% confidence interval [CI] 2.90-3.49) per 1000 person-years in the migraine group and 1.54 (95% CI 1.34-1.76) per 1000 person-years in the non-migraine group. Compared to the non-migraine group, the crude hazard ratio of RA for the migraine group was 2.15 (95% CI 1.82-2.56, P < 0.0001), and the multivariable-adjusted hazard ratio was 1.91 (95% CI 1.58-2.31, P < 0.0001). This study showed that patients with migraine had an increased risk of developing RA.

Identifying Natural Subgroups of Migraine Based on Comorbidity and Concomitant Condition Profiles: Results of the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study

“…The presence of one pain disorder may increase the likelihood of another pain disorder such as migraine. 12 There is strong clinical rationale to identify any underlying pathogenesis in different subclassifications of migraine. 50 Similarly, dysfunction of the serotonergic system may represent the underlying pathogenic mechanism linking pain conditions such as rheumatoid arthritis and migraine.…”

“…2 Etiologic classification (ie, classification based on a known underlying cause) of migraine is most advanced for rare forms of migraine such as familial hemiplegic migraine. Migraine is associated with a number of comorbidities, particularly asthma, 7 cardiovascular disease, [8][9][10] anxiety and depression, 11 arthritis, 12 and chronic pain conditions. 5,6 Concomitant conditions are diseases or disorders that occur together in the same individual.…”

“…Comorbid disorders co-occur in the same individual with greater than chance frequency. Migraine is associated with a number of comorbidities, particularly asthma, 7 cardiovascular disease, [8][9][10] anxiety and depression, 11 arthritis, 12 and chronic pain conditions. 13 Many comorbidities have a higher relative frequency in persons with CM in comparison with episodic migraine (EM).…”

Painful musculosceletal disorders and depression among working aged migraineurs

“…5,6 Pathophysiology linking these painful disorders remains poorly understood; suggested mechanisms include involvement of peripheral and central sensitization disturbances. 8,9 The aim of our study was to evaluate the occurrence and risk of some comorbid and common painful musculoskeletal disorders such as fibromyalgia, osteoarthrosis, sciatic syndrome, rheumatoid arthritis and depression among migraineurs in a working aged population in Finland. 8,9 The aim of our study was to evaluate the occurrence and risk of some comorbid and common painful musculoskeletal disorders such as fibromyalgia, osteoarthrosis, sciatic syndrome, rheumatoid arthritis and depression among migraineurs in a working aged population in Finland.…”

“…3,7 Neural sensitization has also been shown in other comorbid painful conditions in migraine, such as rheumatoid arthritis (RA) and osteoarthritis (OA). 8,9 The aim of our study was to evaluate the occurrence and risk of some comorbid and common painful musculoskeletal disorders such as fibromyalgia, osteoarthrosis, sciatic syndrome, rheumatoid arthritis and depression among migraineurs in a working aged population in Finland. The aim is relevant as depression, and the pain conditions under study are reported to be common disabling conditions in the workforce.…”