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The Journal of Musculoskeletal Medicine. Vol. 27 No. 4

MUSCULOSKELETAL
Citations


Concise summaries of recent journal articles chosen for clinical significance

 

Comorbidity patterns vary with rheumatologic disease

April 6, 2010

Wolfe F, Michaud K, Li T, Katz RS, National Data Bank for Rheumatic Diseases and the University of Kansas School of Medicine, Wichita, and other centers. Chronic conditions and health problems in rheumatic diseases: comparisons with rheumatoid arthritis, noninflammatory rheumatic disorders, systemic lupus erythematosus, and fibromyalgia. J Rheumatol. 2010;37:305-315.


Separate patterns of comorbidity are identified in patients who have fibromyalgia syndrome (FMS), systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and noninflammatory rheumatic disorders (NIRD). The patterns include the type of comorbid variables reported and their associations with age and disease duration.

Wolfe and associates examined the prevalence of lifetime and current comorbidities and their impact on quality of life in 1316 patients with SLE, 2733 with FMS, 13,722 with RA, and 3623 with NIRD. Participants were enrolled in a longitudinal study of rheumatologic disease outcomes.

Comorbidity was most common in persons with FMS; there was a pattern of increase in depression, mental illness, and addiction and a second pattern that involved asthma, allergies, GI problems, neurological issues, and genitourinary diseases. Persons with SLE had hypertension; depression; cataracts; fractures; and cardiovascular, cerebrovascular, neurological, pulmonary, and gallbladder diseases. The most common conditions to accompany RA were hypertension, endocrine problems, psychiatric problems, GI distress, depression, cataracts, and diabetes mellitus. The comorbidity index increased with age in persons with RA or NIRD but remained steady between ages 35 and 84 years for persons with FMS or SLE.

The authors noted that not all coexistent conditions are comorbid.

 

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