Comorbidity burden in the first three years after diagnosis in patients with rheumatoid arthritis, psoriatic arthritis or spondyloarthritis: a general practice registry-based study. Issue 2 (22nd June 2021)

• Record Type: Journal Article
• Authors: Stouten, Veerle; Pazmino, Sofia; Verschueren, P; Mamouris, Pavlos; Westhovens, René; de Vlam, Kurt; Bertrand, Delphine; Van der Elst, Kristien; Vaes, Bert; De Cock, Diederik
• Is Part Of: RMD open. Volume 7:Issue 2(2021)
• Publication Date: 2021-06-22
• Subjects: rheumatoid arthritis -- psoriatic arthritis -- spondyloarthritis -- epidemiology; Musculoskeletal system -- Diseases -- Periodicals; Rheumatism -- Periodicals; 616.7005
• DOI: 10.1136/rmdopen-2021-001671
• Languages: English
• ISSNs: 2056-5933

Abstract

Abstract : Objectives: Rheumatoid arthritis (RA), psoriatic arthritis (PsA) and spondyloarthritis (SpA) are chronic inflammatory rheumatic conditions with high levels of comorbidity requiring additional therapeutic attention. We aimed to compare the 3-year comorbidity incidence and pain medication prescription in patients diagnosed with RA, PsA or SpA versus controls. Methods: Data between 1999 and 2012 were obtained from Intego, a general practitioner (GP) morbidity registry in Flanders, Belgium. Cases were identified by International Classification of Primary Care (ICPC-2) codes representing 'rheumatoid/seropositive arthritis (L88)' or 'musculoskeletal disease other (L99)'. The registered keywords mapped to these ICPC-2 codes were further verified and mapped to a RA/SpA/PsA diagnosis. Controls were matched on age, gender, GP practice and diagnosis date. We analysed the 3-year comorbidity burden in cases and controls, measured by the Rheumatic Diseases Comorbidity Index (RDCI). All electronically GP-prescribed drugs were registered. Results: In total, 738, 229 and 167 patients were included with a diagnosis of RA, SpA or PsA, respectively. Patients with RA or PsA had comparable median RDCI scores at baseline, but higher scores at year 3 compared with controls (RA: p=0.010; PsA: p=0.008). At baseline, depression was more prevalent in PsA patients vs controls (p<0.003). RA patients had a higher 3-year incidence of cardiovascular disease including myocardial infarction than controls (p<0.035). All disease population were given more prescriptions than controls for any pain medication type, even opioids excluding tramadol. Conclusions: This study highlights the increasing comorbidity burden of patients with chronic inflammatory rheumatic conditions, especially for individuals with RA or PsA. The high opioid use in all populations was remarkable.