POS0560\u2005CO-MORBIDITIES MAY NOT CHANGE TREATMENT CHARACTERISTICS OF THE RHEUMATOID ARTHRITIS PATIENTS

Abstract

Several co-morbidities may usually accompany rheumatoid arthritis (RA)(1). These can have direct or indirect implications for the severity of rheumatoid arthritis, the doctors’ decision of disease-modifying treatment, and the functional disability of RA patients.It has been previously shown that various co-morbidities can have negative effects on the functional status, quality of life and life expectancy of RA patients individually (2). Here, we evaluated the effect of weight of all co-morbidities on treatment of RA patients and functional disability. Our hypothesis “The functional status of RA patients with moderate and severe co-morbidities is impaired compared to patients with mild co-morbidities, and the treatment characteristics of RA are different between these groups”.We included 246 RA patients who met the ACR / EULAR 2010 rheumatoid arthritis classification criteria. We divided the patients into two groups according to the Charlson comorbidity index (scores 0-2 mild,> 2 moderate and severe) (3). We compared the functional status of the two groups assessed by the health assessment questionnaire disability index (HAQ-DI). In addition, we compared disease-related characteristics between groups. We performed the Mann-Whitney U and chi-square tests where appropriate. Lastly, we also adjusted the age when comparing the continuous variables with ANCOVA.The patients with moderate and severe co-morbidities were older (p<0.001). All other demographic features were similar between the groups. Extra-articular involvement was more frequent in moderate and severe co-morbidity group (p=0.03). All other disease features and treatment modalities were similar between the groups. Additionally, after adjusting the age, none of the continuous features were different between the groups.Table 1.Disease and demographic features and treatment characteristics of the patients.Mildco-morbidity group(n=180)Moderate and severe co-morbidity group(n=66)Pp**(age adjusted)Age (year)44.5±9.265.0±7.0P<0.001N/AGender (M/F)34/14616/500.5Smoking (%)24 (13.3)7 (10.6)0.63Charlson co-morbidity index1.38±0.483.3±0.6p<0.001p<0.001Disease duration (month)65.2±77.165.1±75.30.970.23Swollen joint0.3±1.50.2±0.60.920.86Tender joint0.6±1.60.3±1.00.380.50ACPA positivity (%)84 (46.6)29 (43.9)0.92RF positivity (%)93 (51.6)66 (58.3)0.39DAS28-CRP2.2±1.22.1±0.70.850.37HAQ-DI0.16±0.200.27±0.390.050.64Extra-articular involvement (%)3 (1.6)5 (7.5)0.03Joint deformity (%)21 (11.6)7 (10.6)077Number of received DMARD1.3±0.51.3±040.550.48Steroid dosage (mg)1.7±2.41.4±1.90.730.60Ever receiving bDMARD (%)21 (11.6)3 (4.5)0.09M: Male; F: Female; ACPA: Anti-Cyclic Citrullinated Peptide Antibody; RF: Rheumatoid factor; DAS-28: Disease activity score-28; HAQ-DI: Health assessment questionnaire disability index; DMARD: Disease modifying drugs; bDMARD: Biologic disease modifying drugs. **For continuous variables. Continuous variables shown as Mean ± SD. p<0.05 is significantThe only different disease feature was the increased frequency of extra-articular involvement in the more severe co-morbidity group. All other disease characteristics were similar. In addition, the severity of the co-morbidities may not change the doctors’ decision to prescribe biological or synthetic DMARDs and steroid dosage.[1]Dougados M, Soubrier M, Antunez A, et al. Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA). Ann Rheum Dis 2014; 73:62-8.[2]Luque Ramos A, Redeker I, Hoffmann F, et al. Comorbidities in Patients with Rheumatoid Arthritis and Their Association with Patient-reported Outcomes: Results of Claims Data Linked to Questionnaire Survey. J Rheumatol 2019; 46:564-571.[3]D’Hoore W, Sicotte C, and Tilquin C. Risk adjustment in outcome assessment: the Charlson comorbidity index. Methods Inf Med 1993; 32:382-7.None declared