Comorbidity Prevalence Examined in Rheumatoid Arthritis vs Systemic Sclerosis
Systemic sclerosis more negatively affected quality of life compared with rheumatoid arthritis.
Systemic sclerosis (SSc) has a comparable cardiovascular risk to rheumatoid arthritis (RA) but more negatively affects quality of life, according to a study published in Arthritis Research & Therapy.
This comparative, multicenter, matched-cohort study sought to compare the prevalence of comorbidities between participants with SSc and RA from 6 rheumatology centers in Greece. The reviewed comorbidities included arterial hypertension, stroke, smoking, chronic obstructive pulmonary disease, neoplasms, osteoporosis, depression, diabetes mellitus, dyslipidemia, and coronary artery disease. The study population included individuals with SSc (n=408) and participants with RA (n=408), matched for gender and age, with comparable disease duration. The SSc cohort included mostly women (89%), 55% with the diffuse subtype, and had a mean age at study inclusion of 58.4±14.5 years.
The results showed participants with RA had a significantly higher body mass index compared with participants with SSc. Comparative analyses on comorbidities showed dyslipidemia (17.7% vs 30.2%; P =.001) and diabetes mellitus (5.6% vs 11.8%; P =.007) were less frequent in SSc and RA, respectively. There were no significant differences noted for arterial hypertension, coronary events, or stroke between cohorts. There were differences in the type of neoplasm observed between the 2 groups, where the SSc group had a high frequency of lung cancer (41%) and RA group had a high frequency for hematologic malignancies (36%) and breast cancer (36%). Depression comorbidities differed between both cohorts, where participants with SSc experienced depression “twice as frequent” compared with the RA cohort.
Identified study limitations include lack of randomization of the RA cohort, deficient information on concomitant immunosuppressive therapies, and not using a standardized questionnaire to measure depression.
The authors concluded the “results indicate that SSc has comparable cardiovascular risk to RA but poses a greater negative impact on quality of life” as participants with SSc are more prone to the onset of depression.
Panopoulos S, Tektonidou M, Drosos AA, et al. Prevalence of comorbidities in systemic sclerosis versus rheumatoid arthritis: a comparative, multicenter, matched-cohort study. Arthritis Res Ther. 2018; 20:267-272.