Arthritis Research & Therapy (Feb 2024)

Impact of multimorbidity on the first ts/bDMARD effectiveness and retention rate after two years of follow-up in patients with rheumatoid arthritis from the BIOBADASER registry

  • Jerusalem Calvo-Gutiérrez,
  • Clementina López-Medina,
  • Lucía Otero-Varela,
  • Alejandro Escudero-Contreras,
  • Rafaela Ortega-Castro,
  • Lourdes Ladehesa-Pineda,
  • Cristina Campos,
  • Pilar Bernabeu-Gonzalvez,
  • Ana Pérez-Gómez,
  • Alicia García-Dorta,
  • Dolores Ruiz-Montesino,
  • Manuel Pombo-Suarez,
  • Inmaculada Ros-Vilamajo,
  • Fernando Sánchez-Alonso,
  • Isabel Castrejón

DOI
https://doi.org/10.1186/s13075-024-03287-9
Journal volume & issue
Vol. 26, no. 1
pp. 1 – 9

Abstract

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Abstract Background Patients with Rheumatoid Arthritis (RA) have a higher prevalence of comorbidities compared to the general population. However, the implications of multimorbidity on therapeutic response and treatment retention remain unexplored. Objectives: (a) To evaluate the impact of multimorbidity on the effectiveness of the first targeted synthetic or biologic disease-modifying antirheumatic drug (ts/bDMARD), in patients with RA after 2-year follow-up; (b) to investigate the influence of multimorbidity on treatment retention rate. Methods Patients with RA from the BIOBADASER registry exposed to a first ts/bDMARDs were included. Patients were categorized based on multimorbidity status at baseline, defined as a Charlson Comorbidity index (CCI) score ≥ 3. A linear regression model, adjusted for sex and age, was employed to compare the absolute DAS28 score over time after ts/bDMARD initiation between the two groups. The Log-Rank test and Kaplan-Meier curve were used to compare the retention rates of the first ts/bDMARD between the groups. Results A total of 1128 patients initiating ts/bDMARD were included, with 107 (9.3%) exhibiting multimorbidity. The linear regression model showed significantly higher DAS28 (beta coefficient 0.33, 95%CI:0.07–0.58) over a two-year period in patients with multimorbidity, even after adjusting for age and sex. Finally, no differences in the ts/bDMARD retention rate were found between groups (median 6.94–6.96 years in CCI < 3 vs. 5.68–5.62 in CCI ≥ 3; p = 0.610). Conclusions Multimorbidity in patients with RA was associated with greater DAS28 scores within the first two years after ts/bDMARD initiation, in comparison with patients without multimorbidity. A slightly shorter retention rate was found in patients with multimorbidity, although the difference was non-significant.

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