There are associations between rheumatoid arthritis (RA) and multiple comorbidities before and after diagnosis, with inflammatory bowel disease, type 1 diabetes, and venous thromboembolism (VTE) occurring more often before RA diagnosis versus controls, according to a study published online Nov. 20 in the Mayo Clinic Proceedings.

Vanessa L. Kronzer, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues performed a case-control study identifying 821 cases of RA (143 incident cases) between Jan. 1, 2009, and Feb. 28, 2018. Each case was age- and sex-matched with three controls. The presence and onset of 74 comorbidities were reported.

The researchers found that 11 comorbidities correlated with RA after adjustment for confounders, including epilepsy, obstructive sleep apnea, and pulmonary fibrosis (odds ratios, 2.13, 1.49, and 4.63, respectively) but not cancer. Compared with controls, inflammatory bowel disease, type 1 diabetes, and VTE occurred more often before RA diagnosis (odds ratios, 3.82, 3.07, and 1.80, respectively). In contrast, compared with controls, myocardial infarction and VTE occurred more often after RA diagnosis (odds ratios, 3.09 and 1.84). These results were mirrored in analyses restricted to incident RA cases and their matched controls.

“Future studies should investigate why the observed overlap between RA and these comorbidities occurs and then examine whether heightened screening for RA and its comorbidities leads to improved outcomes,” the authors write.

Two authors disclosed financial ties to the biopharmaceutical industry.

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