Comorbidity Profiles in Inflammatory Rheumatic Diseases: An Analytical Perspective

Abstract

Background. Inflammatory rheumatic diseases (IRDs) are often associated with multiple comorbidities. Managing comorbidities now seen as important as management of primary IRDs. The aim of this study was to analyse the profiles and prevalence of comorbidities in patients with IRDs and also to highlight the critical need for comprehensive and routine screening for comorbidities. Methods. This study was a retrospective single-center study conducted between 2019 and 2023. IRDs were classified according to the following categories: rheumatoid arthritis, spondyloarthritis, connective tissue diseases, autoinflammatory diseases, Behçet’s disease, large vessel vasculitis (LVV), small vessel vasculitis (SVV), and crystal deposition diseases (CDD). The demographic characteristics and comorbidities (including hypertension, diabetes mellitus, hyperlipidemia, obesity, coronary artery disease, arrhythmia, heart failure, chronic kidney disease, asthma, osteoporosis, thyroid diseases, demyelinating diseases, depression, and malignancies) were obtained from the electronic patient files. Results. The study included 10 417 patients with IRDs (mean age 50.9 ± 14.5 years; 66.8% female). The five most prevalent comorbidities were hypertension (34.8%), obesity (29.1%), diabetes mellitus (14.1%), hyperlipidemia (12.1%), and osteoporosis (9.2%). The Poisson regression analysis demonstrated a significant association between the total number of comorbidities and CDD, LVV, and SVV. The most prevalent comorbidities were cardiovascular risk factors. Furthermore, the prevalence of osteoporosis was high in LVV, and the prevalence of chronic kidney disease and asthma was high in SVV. Conclusion. Our study not only presents observational data but also highlights the critical need for comprehensive and routine screening for comorbidities in patients with rheumatic diseases. We found that CDD followed by LVV and SVV were identified as the rheumatic conditions most associated with comorbidities, and these diseases are most commonly accompanied by cardiovascular risk factors. Additionally, our findings suggest that patients with rheumatological conditions may be underscreened, leading to potential underdiagnosis of comorbidities such as hyperlipidemia, osteoporosis, and possibly malignancies.