Findings of a recent population-based study published in the BMJ journal RMD Open have reported significantly higher prevalence of multimorbidity on RA patients. The study has also corroborated the list of 44 morbidities and other morbidities of interest noted in RA.
Clinical decision making is often challenging in RA patients due to the presence of multiple chronic conditions. Cynthia and colleagues examined the prevalence of 44 previously defined morbidities and 78 nonoverlapping chronic disease categories among residents of eight Minnesota counties (1,643 patients with RA and 1,643 non-RA individuals). Corresponding prevalence of multimorbidities noted in RA patients and non-RA subjects were 86% and 71%, with the presence of 5 or more morbidities present in 55% and 38% of the participants, respectively. Compared to non-RA subjects, significantly higher prevalence of morbidities was noted in RA patients (24 of the 44), particularly, fibromyalgia, osteoarthritis, interstitial lung disease, and osteoporosis. Among the additional 78 categories, the prevalence of 7 morbidities were found to be significantly higher in RA patients including organic sleep disorders, vitamin D deficiency, and foot ulcers.
Previous literature evidence shows that the prevalence of multimorbidity has been underestimated, especially in studies involving younger RA population. The new study providing a comprehensive assessment of morbidities in patients with RA could be clinically useful in easier adoption of International Classification of Diseases (ICD)-9/10 code sets. The study has also identified additional morbidities that may impact RA patients namely vitamin D deficiency, hypercalcemia, sinusitis, allergic rhinitis, erectile dysfunction, skin ulcers, foot deformities thrombocytopenia, leucopenia, restless legs, and sleep apnea.
Reference: Crowson CS, Gunderson TM, Dykhoff HJ, et al. Comprehensive assessment of multimorbidity burden in a population-based cohort of patients with rheumatoid arthritis. RMD Open. 2022;8(1):e002022.