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Rheumatoid arthritis (RA) doesn’t exist in a bubble, and many patients simultaneously have other ailments like heart disease, depression, and diabetes. Having co-existing conditions, also known as comorbidities, can make managing your RA and overall health that much more complicated. So perhaps it’s not surprising that RA patients with certain comorbidities tend to have more severe rheumatoid arthritis, according to a recent study.

The study, which was published in the journal Rheumatology, focused on 379 people with RA. Of that group, 167 (44 percent) had at least one comorbidity, the most frequent being hypertension, or chronic high blood pressure (22 percent).

The researchers were specifically interested in comorbid conditions that had already been deemed “clinically important” for RA patients and were part of the Rheumatic Diseases Comorbidity Index (RDCI), which gives weight to the significance of specific conditions. Those conditions include hypertension, cardiovascular disease, lung disease, peptic ulcer or stomach disease, depression, diabetes, cancer, and bone fractures (of the spine, leg, or hip).

Throughout the two-year study, researchers measured patients’ disease activity, physical function, and quality of life using various assessments. Through this, the researchers found that rheumatoid arthritis patients who had at least one of the previously mentioned comorbidities when the study began fared worse at the end: they were more likely to have disabilities and trouble functioning in everyday life. They also had an increased risk of being hospitalized compared to patients who did not have comorbidities. This held true even when the researchers adjusted for factors like older age, sex, BMI, smoking status, and symptom duration. Treating their RA aggressively with medication(s) didn’t seem to help, either.

“Having comorbidities in the early disease stage was also related with higher disease activity over two years after treatment initiation, even when adjusted for possible confounders,” the authors wrote. “Rheumatologists should be aware of this and take into account comorbidities in their RA management plan, instead of keeping too narrow a focus on controlling RA disease activity.”

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Stouten V, et al. Having a co-morbidity predicts worse outcome in early rheumatoid arthritis despite intensive treatment: a post hoc evaluation of the pragmatic randomized controlled CareRA trial. Rheumatology. January 12, 2021. doi: https://doi.org/10.1093/rheumatology/keaa841.

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