Self-reported comorbidity is common in early inflammatory arthritis and associated with poorer function and worse arthritis disease outcomes: results from the Canadian Early Arthritis Cohort

Hitchon, Carol; Boire, Gilles; Haraoui, Boulos; Keystone, Ed; Pope, Janet; Jamal, Shahin; Tin, D.; Thorne, Carter; Bykerk, Vivian P.

doi:10.1093/rheumatology/kew061

Cited by 30 publications

(24 citation statements)

References 41 publications

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“…In men, we found that seropositivity and pulmonary disease were negatively associated with MetS. This appears counterintuitive to the notion that autoantibodies and extra‐articular disease—long regarded as poor prognostic markers of RA—typically lead to greater, not less, comorbidity burden . Whether these relationships may be mediated by the effects of past cigarette smoking, which was more common in men with MetS, or a surveillance bias in MetS detection is not clear and will require additional investigation.…”

Section: Discussioncontrasting

confidence: 76%

“…We performed a cross‐sectional study using data from the Canadian Early Arthritis Cohort (CATCH) from inception in January 2007 through March 2017. CATCH is a multicenter, prospective, observational study of early inflammatory arthritis . Participants underwent standardized assessments at fixed intervals, including disease activity measures, medication review, and comorbidity profiling (by physician and self‐report).…”

Section: Methodsmentioning

confidence: 99%

“…In RA, the majority of studies has not found significant differences in MetS prevalence between men and women . These have largely focused on patients with established RA, and results may not be generalizable to ERA where initial disease activity, RA management algorithms, and screening/management of comorbidity may be different . The few studies exploring this topic in ERA have focused estimates of MetS in comparison with non‐RA controls only and have not explored sex‐specific variations in MetS components and associated factors .…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and Characteristics of Metabolic Syndrome Differ in Men and Women with Early Rheumatoid Arthritis

Kuriya

Schieir

Valois³

et al. 2019

ACR Open Rheumatology

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on behalf of CATCH investigatorsObjective. Metabolic syndrome (MetS) prevalence in early rheumatoid arthritis (ERA) is conflicting. The impact of sex, including menopause, has not been described. We estimated the prevalence and factors associated with MetS in men and women with ERA.Methods. A cross-sectional study of the Canadian Early Arthritis Cohort (CATCH) was performed. Participants with baseline data to estimate key MetS components were included. Sex-stratified logistic regression identified baseline variables associated with MetS.Results. The sample included 1543 participants; 71% were female and the mean age was 54 (SD 15) years. MetS prevalence was higher in men 188 (42%) than women 288 (26%, P < 0.0001) and increased with age. Frequent MetS components in men were hypertension (62%), impaired glucose tolerance (IGT, 40%), obesity (36%), and low high-density lipoprotein cholesterol (36%). Postmenopausal women had greater frequency of hypertension (65%), IGT (32%), and high triglycerides (21%) compared with premenopausal women (P < 0.001). In multivariate analysis, MetS was negatively associated with seropositivity and pulmonary disease in men. Increasing age was associated with MetS in women. In postmenopausal women, corticosteroid use was associated with MetS. Psychiatric comorbidity was associated with MetS in premenopausal women. MetS status was not explained by disease activity or core RA measures.Conclusion. The characteristics and associations of MetS differed in men and women with ERA. Sex differences, including postmenopausal status, should be considered in comorbidity screening. With this knowledge, the interplay of MetS, sex, and RA therapeutic response on cardiovascular outcomes should be investigated.

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Section: Discussioncontrasting

confidence: 76%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence and Characteristics of Metabolic Syndrome Differ in Men and Women with Early Rheumatoid Arthritis

Kuriya

Schieir

Valois³

et al. 2019

ACR Open Rheumatology

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“…Depression, when comorbid with RA, for example, is associated with an increased risk of incident myocardial infarction , poor quality of life , and increased mortality . Among persons with recently diagnosed RA, psychiatric comorbidity at onset, particularly depression, is associated with greater pain and poorer functional status at onset, and a 40% reduced likelihood of clinical remission at 1 year . In a secondary analysis of a clinical trial, symptoms of depression and anxiety were associated with a reduced likelihood of RA remission .…”

Section: Introductionmentioning

confidence: 93%

Increased Burden of Psychiatric Disorders in Rheumatoid Arthritis

Marrie

Hitchon

Walld

et al. 2018

Arthritis Care & Research

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111

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ObjectiveWe estimated the incidence and prevalence of depression, anxiety disorder, bipolar disorder, and schizophrenia in a population‐based cohort with rheumatoid arthritis (RA) as compared to an age‐, sex‐, and geographically matched cohort without RA.MethodsUsing population‐based administrative health data from Manitoba, Canada, we identified persons with incident RA between 1989 and 2012, and a cohort from the general population matched 5:1 on year of birth, sex, and region of residence. We applied validated algorithms for depression, anxiety disorder, bipolar disorder, and schizophrenia to determine the annual incidence of these conditions after the diagnosis of RA, and their lifetime and annual period prevalence. We compared findings between cohorts using negative binomial regression models.ResultsWe identified 10,206 incident cases of RA and 50,960 matched individuals. After adjustment for age, sex, socioeconomic status, region of residence, number of physician visits, and year, the incidence of depression was higher in the RA cohort over the study period (incidence rate ratio [IRR] 1.46 [95% confidence interval (95% CI) 1.35–1.58]), as was the incidence of anxiety disorder (IRR 1.24 [95% CI 1.15–1.34]) and bipolar disorder (IRR 1.21 [95% CI 1.00–1.47]). The incidence of schizophrenia did not differ between groups (IRR 0.96 [95% CI 0.61–1.50]). Incidence rates of psychiatric disorders declined minimally over time. The lifetime and annual period prevalence of depression and anxiety disorder were also higher in the RA than in the matched cohort over the study period.ConclusionThe incidence and prevalence of depression, anxiety disorder, and bipolar disorder are elevated in the RA population as compared to a matched population.

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“…This is also true in early RA. In the Canadian Early Arthritis cohort, comorbidities were associated with higher disease activity and worse functional status 8 . Indeed, comorbidities have been reported to be a negative predictor of achieving the treatment target, with lower rate of remission or of low disease activity in multimorbid patients with RA.…”

mentioning

confidence: 99%

Shifting from a Rheumatologic Point of View toward Patient-centered Care in Rheumatoid Arthritis with an Integrated Management of Comorbidities

2019

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Self-reported comorbidity is common in early inflammatory arthritis and associated with poorer function and worse arthritis disease outcomes: results from the Canadian Early Arthritis Cohort

Cited by 30 publications

References 41 publications

Prevalence and Characteristics of Metabolic Syndrome Differ in Men and Women with Early Rheumatoid Arthritis

Prevalence and Characteristics of Metabolic Syndrome Differ in Men and Women with Early Rheumatoid Arthritis

Increased Burden of Psychiatric Disorders in Rheumatoid Arthritis

Shifting from a Rheumatologic Point of View toward Patient-centered Care in Rheumatoid Arthritis with an Integrated Management of Comorbidities

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