Points to consider for reporting, screening for and preventing selected comorbidities in chronic inflammatory rheumatic diseases in daily practice: a EULAR initiative

Abstract

In chronic inflammatory rheumatic diseases, comorbidities such as cardiovascular diseases and infections are suboptimally prevented, screened for and managed. The objective of this European League Against Rheumatism (EULAR) initiative was to propose points to consider to collect comorbidities in patients with chronic inflammatory rheumatic diseases. We also aimed to develop a pragmatic reporting form to foster the implementation of the points to consider. In accordance with the EULAR Standardised Operating Procedures, the process comprised (1) a systematic literature review of existing recommendations on reporting, screening for or preventing six selected comorbidities: ischaemic cardiovascular diseases, malignancies, infections, gastrointestinal diseases, osteoporosis and depression and (2) a consensus process involving 21 experts (ie, rheumatologists, patients, health professionals). Recommendations on how to treat the comorbidities were not included in the document as they vary across countries. The literature review retrieved 42 articles, most of which were recommendations for reporting or screening for comorbidities in the general population. The consensus process led to three overarching principles and 15 points to consider, related to the six comorbidities, with three sections: (1) reporting (ie, occurrence of the comorbidity and current treatments); (2) screening for disease (eg, mammography) or for risk factors (eg, smoking) and (3) prevention (eg, vaccination). A reporting form (93 questions) corresponding to a practical application of the points to consider was developed. Using an evidence-based approach followed by expert consensus, this EULAR initiative aims to improve the reporting and prevention of comorbidities in chronic inflammatory rheumatic diseases. Next steps include dissemination and implementation.

Comorbidities in rheumatoid arthritis

“…There is a EULAR ongoing initiative aimed at providing recommendations (points to consider) to standardize the way of collecting the information related to the reporting, screening and preventing of the most frequently observed comorbidities in rheumatoid arthritis [54].…”

The 2016 Eular Guidelines for the Diagnosis and Treatment of Early Arthritis

“…Эта рекомендация, основанная на мнении экспер-тов, учитывает данные многочисленных исследований, подтверждающих значение профилактики и лечения ко-морбидной патологии (инфекции, кардиоваскулярные и метаболические заболевания, поражение легких, остео-пороз, депрессия, злокачественные новообразования) для улучшения прогноза у пациентов с ранним артритом [105][106][107][108][109][110][111]. Установлено, что коморбидность влияет на про-должительность жизни, функциональный статус и качест-во жизни пациентов независимо от активности заболева-ния, снижает эффективность терапии и увеличивает риск НР.…”

Is Fragility Fracture a Strong Risk Factor for a Cardiovascular Event in Rheumatoid Arthritis? The Challenge of Dealing with Multiple Comorbidities

“…If confirmed, we will have better insight into the additional risk for RA patients for CV events after an FF, preferably with data for subcategories of RA patients with severe or mild RA. Interestingly, it was recently mentioned by the European League Against Rheumatism that comorbidities are often suboptimally prevented, screened, and managed 19 . Nevertheless, in an aging population, our patients expect from us as rheumatologists: optimal care and treatment not only for their rheumatic disease, but also for their comorbidities.…”