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Comorbidity Burden in Rheumatic Diseases

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Front. Med. | doi: 10.3389/fmed.2018.00035

Comorbidities in anti-CCP positive at-risk individuals do not differ from those patients with early inflammatory arthritis.

 Sarah Twigg1, 2*,  Elena Nikiphorou3, Jackie L. Nam2, 4, Laura Hunt2, 4, Kulveer Mankia2, 4, Peta E. Pentony2, 4, Jane E. Freeston2, 4,  Ai Lyn Tan2, 4 and  Paul Emery2, 4
  • 1Rheumatology, Bradford Teaching Hospitals NHS Foundation Trust, United Kingdom
  • 2Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, United Kingdom
  • 3Academic Rheumatology Department, King's College London, United Kingdom
  • 4Leeds Biomedical Research Centre (NIHR), United Kingdom

Objectives: To compare comorbidities in a cohort of cyclic citrullinated peptide (CCP) antibody positive patients without or prior to onset of inflammatory arthritis (IA), to those in patients with early IA.
Methods: Baseline data from two established cohorts were used. The first recruited people at risk of IA: CCP antibody positive cases without IA (CCP Cohort, n=296). The second cohort (the Inflammatory Arthritis CONtinuum study, IACON) recruited patients with early IA (n=725). Proportions of patients with given comorbidities were compared between cohorts and then logistic regression was used to determine odds ratios (OR) for the CCP cohort having specific comorbidities, compared to IACON patients. Analyses adjusted for gender, age, smoking status and body mass index.
Results: Patients from the CCP cohort were younger (mean age 50, compared to 53 years). The proportion of patients with at least one comorbidity was higher in the IACON than the CCP cohort: (40% compared to 24%, respectively). Results of logistic regression analyses suggested the odds of hypertension, taking a lipid lowering agent, ischaemic heart disease, cerebrovascular disease, lung disease and diabetes were not increased in either cohort. However, patients in the CCP cohort were more likely to be taking an antidepressant (OR = 1.62, 95% CI 1.03, 2.56, p=0.037).
Conclusion: There was no significant difference in comorbidities amongst people with CCP antibodies but without inflammatory arthritis, compared to those of patients with established inflammatory arthritis.

Keywords: comorbidities, Inflammatory arthritis, Rheumatoid arthritis, CCP antibodies, At-risk of arthritis, depression and anxiety disorders

Received: 14 Oct 2017; Accepted: 30 Jan 2018.

Edited by:

Dimitrios Vassilopoulos, National and Kapodistrian University of Athens Medical School, Greece

Reviewed by:

Nancy Vivar, Karolinska University Hospital, Sweden
Cristiano Fava, University of Verona, Italy  

Copyright: © 2018 Twigg, Nikiphorou, Nam, Hunt, Mankia, Pentony, Freeston, Tan and Emery. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Sarah Twigg, Bradford Teaching Hospitals NHS Foundation Trust, Rheumatology, Bradford Royal Infirmary, Duckworth Lane, Bradford, United Kingdom, S.twigg@leeds.ac.uk