scholarly journals FRI0603-HPR COMORBIDITIES IN RHEUMATOID ARTHRITIS: UTILITY OF RACI SCORE (RHEUMATOID ARTHRITIS COMORBIDITY INDEX)

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 907.3-908
Author(s):  
Y. Soria Curi ◽  
L. Gonzalez Lucero ◽  
F. J. Hüttmann ◽  
M. L. Leguizamón ◽  
S. M. Mazza ◽  
...  

Background:One third of patients with rheumatoid arthritis have some comorbidity at the time of diagnosis and 80% during the evolution. The presence of each additional comorbidity reduces the chances of remission by 28%.Objectives:To determine the prevalence of comorbidities in Rheumatoid Arthritis (RA) and to evaluate associated variables.Methods:A descriptive cross-sectional study was conducted. It were included patients over 18 years of age, who attended the Rheumatology office between May and August 2018 with a diagnosis of RA according to the ACR 1987 and ACR/EULAR 2010 criteria. Demographic variables were studied along with disease-related variables (time of evolution, disease activity by DAS-28 and CDAI, treatment and functional capacity (HAQ-A)). The presence of comorbidities was evaluated using two indexes: Rheumatoid Arthritis Comorbidity Index (RACI) and Disease Comorbidity Index (RDCI). RACI consists of 31 comorbidities grouped into 11 categories: DAS 28 >3.6, local inflammation, smoking, tumors, systemic involvement, infection, vascular disease, bone health, mood, metabolic and cardiovascular disorders (score range 0-36). RDCI consists of 11 comorbidities (categories according to ICD-10) and a formula to calculate it (range 0-9). For both indexes; higher score, greater comorbidity.Results:In this cross-sectional study, 345 patients were evaluated, of which 176 were included, 85.8% of the patients were female and the mean age was 52.7 ± 10.9 years; 31.2% of the cases finished primary school, the median of disease duration was 9 years (1-40), the mean DAS28 3.8 ± 1.4, and the mean CDAI 12.4 ± 11.3. 52.3% of the patients received treatment with glucocorticoids, 60.8% with NSAID, 60.2% with methotrexate, 39.2% with leflunomide, 17.6% with biologic DMARds and 5.6% with tofacitinib. 90.3% of the patients (95% CI 84.8, 94.3) presented some comorbidity measured by RACI. The average score was 4.7 ± 3.4 and the most frequent comorbidity were: elevated DAS28 (40.9%), dyslipidemia (38.1%), AHT (36.4%), prednisone >5 mg/d in 31.8%, endocrinopathies 19.3%. 73.3% of the patients had more than one comorbidity. Regarding RDCI, 47.2% of the cases presented some comorbidity with an average score of 0.95 ± 1.3; the most frequent were: AHT 36.4%, lung disease 12.5% and diabetes 8%. The oldest patients had more than one comorbidity (RACI), and also presented a higher HAQ score than those with only one (p<0.0001). Higher RACI score was associated with higher CDAI (p<0.001) and the use of glucocorticoids (p=0.008).Conclusion:The prevalence of comorbidities in RA by RACI was elevated (90.3%) and 73.3% of the patients presented more than one comorbidity. The patients with the highest RACI score had higher disease activity and used glucocorticoids more frequently.Disclosure of Interests:None declared

2019 ◽  
Vol 6 (3) ◽  
pp. 628
Author(s):  
K. M. Prabhuswamy ◽  
M. Virgin Joena

Background: IMT assessment as a non-invasive imaging test is quite widely used especially among RA patients, the clinical applications of using such knowledge is scarce, hence study was conducted to compare the carotid artery intima-media thickness (CIMT) in patients with rheumatoid arthritis (RA) with healthy controls also to study the correlation between duration of rheumatoid arthritis, the activity of rheumatoid arthritis and other factors influencing (CIMT).Methods: In analytical cross-sectional study, of 80 participants of RA and 40 healthy controls, “DAS28” was used to assess disease activity.  Carotid intima-media thickness assessed using carotid ultrasonography.Results: Mean age of the cases and controls was 43.9 and 44.38 years. Subjects with duration of disease <2 years, to 5 years and >5 years were 35%, 45% and 20%. The mean carotid intima-media thickness was 5.61mm in controls, and CIMT was 6.11mm in people below 2 years and 7.08 mm in people between 2 to 5 years and 8.00mm in people above 5 years which was statistically significant. The mean carotid intima-media thickness was 5.61mm controls and 6.86mm in people with low, 7.00mm in people with moderate and 6.95mm in people with high disease activity, which was statistically significant.Conclusions: Study findings revealed risk of increase in carotid intima-media thickness higher among RA patients in the later stages and can increase the patients’ susceptibility to cardiovascular events. The factors showing strong association with intimal medial thickness were the age and symptoms duration.


2021 ◽  
Vol 48 (1) ◽  
Author(s):  
Eman A. Baraka ◽  
Mona G. Balata ◽  
Shereen H. Ahmed ◽  
Afaf F. Khamis ◽  
Enas A. Elattar

Abstract Background This study aimed to measure the serum and synovial interleukin (IL)-37 levels in rheumatoid arthritis (RA) patients compared to patients with primary knee osteoarthritis (PKOA) and healthy controls and to detect its relation to RA disease activity. Results This cross-sectional study included 50 RA patients with a mean age of 40.24 ± 8.62 years, 50 patients with PKOA with a mean age of 56.69 ± 4.21, and 40 healthy controls with a mean age of 41.75 ± 7.38 years. The mean serum IL-37 level in the RA patients (382.6 ± 73.97 pg/ml) was statistically significantly (P < 0.001) the highest among the studied groups; however, it showed a non-significant difference between the PKOA patients (70.38 ± 27.49 pg/ml) and the healthy controls (69.97 ± 25.12 pg/ml) (P > 0.94). Both serum and synovial IL-37 levels were significantly positively correlated with disease activity scores (r = 0.92, P< 0.001 and r = 0.85, P < 0.001), tender joint counts (r = 0.83, P < 0.001 and r = 0.82, P < 0.001 ), swollen joint counts (r = 0.72, P < 0.001 and r = 0.60, P < 0.001), visual analog scale (r = 0.82, P < 0.001 and r = 0.82, P < 0.001), erythrocyte sedimentation rate (r = 0.75, P < 0.001 and r = 0.65, P < 0.001), and C-reactive protein (r = 0.93, P < 0.001 and r = 0.79, P < 0.001), respectively. Conclusion Serum and synovial IL-37 were significantly elevated in the RA patients, and they were closely correlated. Being less invasive, the serum IL-37 could be a marker of disease activity and could reflect the effective disease control by drugs. Having an anti-inflammatory effect could not suggest IL-37 as the key player to control inflammation alone, but its combination with other anti-proinflammatory cytokines could be investigated.


2020 ◽  
Vol 50 (6) ◽  
pp. 1540-1545
Author(s):  
Ömer Faruk ELMAS ◽  
Mehmet OKÇU ◽  
Abdullah DEMİRBAŞ ◽  
Necmettin AKDENİZ

Background/aim: Nailfold video capillaroscopy is considered as a reliable method for evaluating peripheral microangiopathy in rheumatologic diseases. In this study, we aimed to demonstrate the utility of handheld dermatoscopy as an easy-to-use nailfold capillaroscopic instrument in patients with rheumatoid arthritis.Materials and methods: This cross-sectional study included patients with rheumatoid arthritis and healthy subjects. A handheld dermatoscopic examination of proximal nail fold was performed in each subject. The possible correlation of capillaroscopic findings with disease activity was evaluated using the disease activity score 28 (DAS28).Results: A total of 59 patients with rheumatoid arthritis and 60 healthy subjects were enrolled in the study. The presence of capillaryenlargement, avascular areas, capillary deformities, and capillary vascular anomalies in the group of patients showed a statistically significant difference when compared with the healthy subjects. No correlation was found between the nail fold capillaroscopic findings and DAS28 score.Conclusion: Hand-held dermatoscopy seems to be a useful technique in the evaluation of nail fold capillary changes. We suggest that in patients with rheumatoid arthritis, when capillaroscopic examination is needed, it can be evaluated using handheld dermatoscopy. Selected patients who showed findings using this method can be further examined with classical capillaroscopy to obtain more quantitative data.


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