RA and Related Conditions Worldwide

Rheumatoid arthritis patients have various comorbidities and treatment patterns

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

As treatments for rheumatoid arthritis have improved, the long-term outlook for patients also has become much better. But other conditions linked to rheumatoid arthritis can still be a barrier to an otherwise healthy life.

A recent study found that rheumatoid arthritis patients throughout the world had a number of other illnesses related to arthritis and risk factors for these related illnesses. These related, or comorbid, conditions included depression, asthma and heart problems.

The study also found that the number of comorbid illnesses, and how patients treated their arthritis, varied greatly from country to country.

The findings show the need to develop and implement standardized programs to help detect, manage and prevent illnesses related to rheumatoid arthritis early on, according to the researchers.

"Tell your doctor if you notice prolonged pain in your joints."

Maxime Dougados, MD, from the Medicine Faculty at Paris-Descartes University in France, led a team of researchers in investigating how often patients with rheumatoid arthritis from different countries had illnesses related to their condition and how they treated those illnesses.

The study included 3,920 patients, most of whom were female, from 17 participating countries. The patients were 56 years of age on average and had been diagnosed with rheumatoid arthritis for at least 10 years.

The participants answered a questionnaire on their disease characteristics, such as the severity of their arthritis and whether they followed their country's national guidelines on how to treat it.

They specifically reported any use of biologic agents and methotrexate (Trexall), a prescription medication used to treat rheumatoid arthritis, as well as several kinds of cancer.

Patients also reported any related conditions such as heart, cancer, gastrointestinal and pulmonary disorders. They also reported infections, osteoporosis and psychiatric issues. 

Based on the questionnaires, the researchers found that the most common diseases tied to rheumatoid arthritis were depression, asthma and heart events, including heart attacks and strokes.

A total of 15 percent of all patients reported depression, about 7 percent had asthma and 6 percent had some kind of heart event.

The average number of people who had these illnesses varied from country to country. Depression for example ranged from 2 percent in Morocco to 33 percent in the US.

The researchers also found malignant, or cancerous, tumors in about 5 percent of patients and chronic obstructive pulmonary disease (COPD) in about 4 percent.

From country to country, the range of people that had comorbid conditions "...was wide, not only in prevalence but also in compliance with recommendations for preventing and managing these comorbidities," the researchers wrote in their report. They also wrote that lab tests and measuring vital signs "...detects otherwise unrecognized comorbid conditions."

The authors noted a few limitations of their study, including that only a select number of comorbidities were included in their analysis, and that the participants might not have been fully representative of all patients with rheumatoid arthritis.

Other limitations included the cultural differences between each country's interpretation of the questionnaires, which may have skewed the results. In addition, the number of illnesses related to rheumatoid arthritis might have resulted from overdiagnosis.

This study, funded by a grant from Roche Ltd., was published online October 4 in the Annals of the Rheumatic Diseases.

The authors declared no conflicts of interest.

Review Date: 
October 11, 2013
Last Updated:
October 17, 2013