ArticleClinical rheumatology2019
Comorbidity burden and clinical characteristics of patients with difficult-to-control rheumatoid arthritis.
Article in Clinical rheumatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Summarizing current refractory disease definitions in rheumatoid arthritis and polyarticular juvenile idiopathic arthritis: systematic review.Rheumatology (Oxford, England) · 2021Pooled it
- Indirect Costs of Rheumatoid Arthritis Depending on Type of Treatment-A Systematic Literature Review.International journal of environmental research and public health · 2019Pooled it
- Clinical Characteristics and Predictors of Primary Non-Response to Biologic Therapy in Rheumatoid Arthritis and Axial Spondyloarthritis.Mediterranean journal of rheumatology · 2026Article
- Article
- Comorbidity Profiles at Diagnosis in Rheumatoid Arthritis Versus Psoriatic Arthritis: A Nationwide Polish Claims-Based Study.Journal of clinical medicine · 2026Article
- Characterising subgroups of difficult-to-treat rheumatoid arthritis in real-world clinical settings.EULAR rheumatology open · 2026Article
- Insights Into Late-Onset Rheumatoid Arthritis (LORA): Characteristics (Clinical and Imaging), Comorbidities, and Therapeutic Targets.Geriatrics & gerontology international · 2026Review
- Factors Associated with Difficult-to-Treat Rheumatoid Arthritis (D2T-RA): Real-World Evidence from a Single-Center Cross-Sectional Study.Journal of personalized medicine · 2026Article
- Comorbidity in incident rheumatoid arthritis: a nationwide case-control study with bidirectional follow-up.Rheumatology (Oxford, England) · 2025Article
- Article
- Obesity and fibromyalgia are associated with Difficult-to-Treat Rheumatoid Arthritis (D2T-RA) independent of age and gender.Arthritis research & therapy · 2025Article
- Profiling of fecal analytes as a potential biomarker in rheumatoid arthritis.Frontiers in immunology · 2025Article
- Disease burden in inflammatory arthritis: an unsupervised machine learning approach of the COVAD-2 e-survey dataset.Rheumatology advances in practice · 2025Article
- Predictors of functional improvement and pain reduction in rheumatoid arthritis patients who achieved low disease activity with disease-modifying antirheumatic drugs: a retrospective study of the FIRST Registry.Arthritis research & therapy · 2024Article
- Current and Future Challenges for Rehabilitation for Inflammatory Arthritis.Journal of clinical medicine · 2024Review
- Unveiling difficult-to-treat rheumatoid arthritis: long-term impact of biologic or targeted synthetic DMARDs from the KOBIO registry.Arthritis research & therapy · 2023Article
- Association of Rheumatoid Arthritis with Opioid Pain Medication Overuse among Persons Exposed to the 9/11 World Trade Center Disaster.International journal of environmental research and public health · 2023Article
- Newly developed cardiovascular risk factors in rheumatoid arthritis patients initiating biologic treatment.Reumatologia · 2023Article
- Association between Rheumatic Disease Comorbidity Index and factors of poor prognosis in a cohort of 280 patients with rheumatoid arthritis.BMC rheumatology · 2022Article
- Difficult-to-Treat Rheumatoid Arthritis in Older Adults: Implications of Ageing for Managing Patients.Drugs & aging · 2022Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDifficult-to-treat rheumatoid arthritis (RA) is a significant clinical problem despite no clear definition. We aimed to provide clinical characteristics and associated comorbidities of RA patients in relation to disease control.
methodsRA characteristics and physician-recorded comorbidities were analyzed in a sample of 1937 RA patients. Patients treated for RA for 5.2 y (IQR, 2.1-11.3) were classified as difficult-to-control when presenting with DAS28-ESR > 3.2 despite previous use of at least 2 csDMARDs. A comparison of demographic and RA-related characteristics between difficult-to-treat and low disease activity patients (DAS28-ESR ≤ 3.2) was performed. Comorbidity burden was assessed by calculating Rheumatic Diseases Comorbidity Index (RDCI). Logistic regression model was constructed for difficult-to-control disease.
resultsHypertension (46.9% (95%CI, 44.7-49.2)), coronary artery disease (CAD) (18.5% (95%CI, 16.8-20.3)), and diabetes (14.4% (95%CI, 12.9-16.0)) were the most prevalent conditions in RA patients. When compared with the adequate control group, difficult-to-control patients were increasingly burdened with hypertension (52.7% (95%CI, 47.5-57.8) vs. 42.0% (95%CI, 36.6-47.6); p = 0.006), cardiovascular diseases (24.2% (95%CI, 20.1-28.9) vs. 11.1% (95%CI, 8.0-15.1); p < 0.001), respiratory system diseases (7.0% (95%CI, 4.8-10.2) vs. 3.3% (95%CI, 1.8-5.9); p = 0.03) and gastroduodenal ulcers (2.3% (95%CI, 1.2-4.4) vs. 0.3% (95%CI, 0.1-1.8); p = 0.04). Patients with higher RDCI had lower chance to obtain low disease activity (OR 0.69 (95%CI, 0.61-0.79); p < 0.001). In multivariate analysis, RDCI was independently associated with difficult-to-control disease (OR 1.46 (95%CI, 1.21-1.76); p < 0.001).
conclusionsRA patients suffer from a variety of comorbidities. Cardiovascular and respiratory system diseases occur twice as often in difficult-to-control patients. RDCI may provide a valuable tool in evaluating a risk for difficult-to-control RA. Key Points • Hypertension, coronary artery disease and diabetes are the most prevalent comorbidities in rheumatoid arthritis. • Cardiovascular and respiratory tract diseases as well as gastroduodenal ulcers are more common among difficult-to-control patients, when compared with subjects with adequately controlled RA. • Rheumatic Diseases Comorbidity Index is an independent predictor for difficult-to-control RA.
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