Evidence map›Paper›PMID 26757209›Full record

Observational studyPloS one2016

Cardiovascular Comorbidities Relate More than Others with Disease Activity in Rheumatoid Arthritis.

Gloria Crepaldi, Carlo Alberto Scirè, Greta Carrara, Garifallia Sakellariou, Roberto Caporali, Ihsane Hmamouchi, Maxime Dougados, Carlomaurizio Montecucco

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 1 pooled it
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Gloria CrepaldiDepartment of Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
Carlo Alberto ScirèEpidemiology Unit, Italian Society for Rheumatology, Milan, Italy.
Greta CarraraEpidemiology Unit, Italian Society for Rheumatology, Milan, Italy.
Garifallia SakellariouDepartment of Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
Roberto CaporaliDepartment of Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
Ihsane HmamouchiMohammed V Souissi University, Faculty of Medicine, Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Rabat, Morocco.
Maxime DougadosRheumatology B Department, Hospital Cochin, Medicine Faculty, Paris-Descartes University, Paris, France.
Carlomaurizio MontecuccoDepartment of Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo explore the influence of comorbidities on clinical outcomes and disease activity in rheumatoid arthritis (RA).

methodsIn patients included in the cross-sectional observational multicenter international study COMORA, demographics, disease characteristics and comorbidities (hypertension, diabetes, hyperlipidemia, renal failure, ischemic heart disease, stroke, cancer, gastro-intestinal ulcers, hepatitis, depression, chronic pulmonary disease, obesity) were collected. Multivariable linear regression models explored the relationship between each comorbidity and disease activity measures: 28-swollen joint count (SJC), 28-tender joint count (TJC), erythrocyte sedimentation rate (ESR), patient's and physician's global assessment (PtGA, PhGA), patient reported fatigue and 28-Disease Activity Score (DAS28). Results are expressed as mean difference (MD) adjusted for the main confounders (age, gender, disease characteristics and treatment).

resultsA total of 3,920 patients were included: age (mean ±SD) 56.27 ±13.03 yrs, female 81.65%, disease duration median 7.08 yrs (IQR 2.97-13.27), DAS28 (mean ±SD) 3.74 ± 1.55. Patients with diabetes had more swollen and tender joints and worse PtGA and PhGA (MD +1.06, +0.93, +0.53 and +0.54, respectively). Patients with hyperlipidemia had a lower number of swollen and tender joints, lower ESR and better PtGA and PhGA (MD -0.77, -0.56, -3.56, -0.31 and -0.35, respectively). Patients with history of ischemic heart disease and obese patients had more tender joints (MD +1.27 and +1.07) and higher ESR levels (MD +5.64 and +5.20). DAS28 is influenced exclusively by cardiovascular comorbidities, in particular diabetes, hyperlipidemia, ischemic heart disease and obesity.

conclusionsCardiovascular comorbidities relate more than others with disease activity in RA. Diabetes and hyperlipidemia in particular seem associated with higher and lower disease activity respectively influencing almost all considered outcomes, suggesting a special importance of this pattern of comorbidities in disease activity assessment and clinical management.

Indexed as

AdultAgedArthritis, RheumatoidCardiovascular DiseasesComorbidityCross-Sectional StudiesFatigueFemaleHumansInternational CooperationJointsMaleMiddle AgedSeverity of Illness IndexTreatment Outcome

Identifiers

PMID26757209
PMCPMC4710534

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.