King's College London

Research portal

Prognostic value of comorbidity indices and lung diseases in early rheumatoid arthritis: a UK population-based study

Research output: Contribution to journalArticle

Standard

Prognostic value of comorbidity indices and lung diseases in early rheumatoid arthritis : a UK population-based study. / Nikiphorou, Elena; de Lusignan, Simon; Mallen, Christian; Roberts, Jacqueline; Khavandi, Kaivan; Bedarida, Gabriella; Buckley, Christopher D.; Galloway, James; Raza, Karim.

In: Rheumatology (Oxford, England), Vol. 59, No. 6, 01.06.2020, p. 1296-1305.

Research output: Contribution to journalArticle

Harvard

Nikiphorou, E, de Lusignan, S, Mallen, C, Roberts, J, Khavandi, K, Bedarida, G, Buckley, CD, Galloway, J & Raza, K 2020, 'Prognostic value of comorbidity indices and lung diseases in early rheumatoid arthritis: a UK population-based study', Rheumatology (Oxford, England), vol. 59, no. 6, pp. 1296-1305. https://doi.org/10.1093/rheumatology/kez409

APA

Nikiphorou, E., de Lusignan, S., Mallen, C., Roberts, J., Khavandi, K., Bedarida, G., ... Raza, K. (2020). Prognostic value of comorbidity indices and lung diseases in early rheumatoid arthritis: a UK population-based study. Rheumatology (Oxford, England), 59(6), 1296-1305. https://doi.org/10.1093/rheumatology/kez409

Vancouver

Nikiphorou E, de Lusignan S, Mallen C, Roberts J, Khavandi K, Bedarida G et al. Prognostic value of comorbidity indices and lung diseases in early rheumatoid arthritis: a UK population-based study. Rheumatology (Oxford, England). 2020 Jun 1;59(6):1296-1305. https://doi.org/10.1093/rheumatology/kez409

Author

Nikiphorou, Elena ; de Lusignan, Simon ; Mallen, Christian ; Roberts, Jacqueline ; Khavandi, Kaivan ; Bedarida, Gabriella ; Buckley, Christopher D. ; Galloway, James ; Raza, Karim. / Prognostic value of comorbidity indices and lung diseases in early rheumatoid arthritis : a UK population-based study. In: Rheumatology (Oxford, England). 2020 ; Vol. 59, No. 6. pp. 1296-1305.

Bibtex Download

@article{8cbd05574f9b425988707acddf816288,
title = "Prognostic value of comorbidity indices and lung diseases in early rheumatoid arthritis: a UK population-based study",
abstract = "OBJECTIVES: We assessed comorbidity burden in people with RA at diagnosis and early disease (3 years) and its association with early mortality and joint destruction. The association between lung disease and mortality in RA is not well studied; we also explored this relationship. METHODS: From a contemporary UK-based population (n = 1, 475 762) we identified a cohort with incident RA (n = 6591). The prevalence of comorbidities at diagnosis of RA and at 3 years was compared with age- and gender-matched controls (n = 6591). In individuals with RA we assessed the prognostic value of the Charlson Comorbidity Index and Rheumatic Disease Comorbidity Index calculated at diagnosis for all-cause mortality and joint destruction (with joint surgery as a surrogate marker). We separately evaluated the association between individual lung diseases [chronic obstructive pulmonary disease (COPD), asthma and interstitial lung disease] and mortality. RESULTS: Respiratory disease, cardiovascular disease, stroke, diabetes, previous fracture and depression were more common (P < 0.05) in patients with RA at diagnosis than controls. Comorbidity (assessed using RDCI) was associated with all-cause mortality in RA [adjusted hazard ratio (HR) 1.26, 95{\%} CI 1.00-1.60]. There was no association with joint destruction. COPD, but not asthma, was associated with mortality (COPD HR 2.84, 95{\%} CI 1.13-7.12). CONCLUSION: There is an excess burden of comorbidity at diagnosis of RA including COPD, asthma and interstitial lung disease. COPD is a major predictor of early mortality in early RA. Early assessment of comorbidity including lung disease should form part of the routine management of RA patients.",
keywords = "asthma, cardiovascular diseases, chronic obstructive pulmonary disease, comorbidity, joint damage, mortality, rheumatoid arthritis",
author = "Elena Nikiphorou and {de Lusignan}, Simon and Christian Mallen and Jacqueline Roberts and Kaivan Khavandi and Gabriella Bedarida and Buckley, {Christopher D.} and James Galloway and Karim Raza",
year = "2020",
month = "6",
day = "1",
doi = "10.1093/rheumatology/kez409",
language = "English",
volume = "59",
pages = "1296--1305",
journal = "Rheumatology",
issn = "1462-0324",
number = "6",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Prognostic value of comorbidity indices and lung diseases in early rheumatoid arthritis

T2 - a UK population-based study

AU - Nikiphorou, Elena

AU - de Lusignan, Simon

AU - Mallen, Christian

AU - Roberts, Jacqueline

AU - Khavandi, Kaivan

AU - Bedarida, Gabriella

AU - Buckley, Christopher D.

AU - Galloway, James

AU - Raza, Karim

PY - 2020/6/1

Y1 - 2020/6/1

N2 - OBJECTIVES: We assessed comorbidity burden in people with RA at diagnosis and early disease (3 years) and its association with early mortality and joint destruction. The association between lung disease and mortality in RA is not well studied; we also explored this relationship. METHODS: From a contemporary UK-based population (n = 1, 475 762) we identified a cohort with incident RA (n = 6591). The prevalence of comorbidities at diagnosis of RA and at 3 years was compared with age- and gender-matched controls (n = 6591). In individuals with RA we assessed the prognostic value of the Charlson Comorbidity Index and Rheumatic Disease Comorbidity Index calculated at diagnosis for all-cause mortality and joint destruction (with joint surgery as a surrogate marker). We separately evaluated the association between individual lung diseases [chronic obstructive pulmonary disease (COPD), asthma and interstitial lung disease] and mortality. RESULTS: Respiratory disease, cardiovascular disease, stroke, diabetes, previous fracture and depression were more common (P < 0.05) in patients with RA at diagnosis than controls. Comorbidity (assessed using RDCI) was associated with all-cause mortality in RA [adjusted hazard ratio (HR) 1.26, 95% CI 1.00-1.60]. There was no association with joint destruction. COPD, but not asthma, was associated with mortality (COPD HR 2.84, 95% CI 1.13-7.12). CONCLUSION: There is an excess burden of comorbidity at diagnosis of RA including COPD, asthma and interstitial lung disease. COPD is a major predictor of early mortality in early RA. Early assessment of comorbidity including lung disease should form part of the routine management of RA patients.

AB - OBJECTIVES: We assessed comorbidity burden in people with RA at diagnosis and early disease (3 years) and its association with early mortality and joint destruction. The association between lung disease and mortality in RA is not well studied; we also explored this relationship. METHODS: From a contemporary UK-based population (n = 1, 475 762) we identified a cohort with incident RA (n = 6591). The prevalence of comorbidities at diagnosis of RA and at 3 years was compared with age- and gender-matched controls (n = 6591). In individuals with RA we assessed the prognostic value of the Charlson Comorbidity Index and Rheumatic Disease Comorbidity Index calculated at diagnosis for all-cause mortality and joint destruction (with joint surgery as a surrogate marker). We separately evaluated the association between individual lung diseases [chronic obstructive pulmonary disease (COPD), asthma and interstitial lung disease] and mortality. RESULTS: Respiratory disease, cardiovascular disease, stroke, diabetes, previous fracture and depression were more common (P < 0.05) in patients with RA at diagnosis than controls. Comorbidity (assessed using RDCI) was associated with all-cause mortality in RA [adjusted hazard ratio (HR) 1.26, 95% CI 1.00-1.60]. There was no association with joint destruction. COPD, but not asthma, was associated with mortality (COPD HR 2.84, 95% CI 1.13-7.12). CONCLUSION: There is an excess burden of comorbidity at diagnosis of RA including COPD, asthma and interstitial lung disease. COPD is a major predictor of early mortality in early RA. Early assessment of comorbidity including lung disease should form part of the routine management of RA patients.

KW - asthma

KW - cardiovascular diseases

KW - chronic obstructive pulmonary disease

KW - comorbidity

KW - joint damage

KW - mortality

KW - rheumatoid arthritis

UR - http://www.scopus.com/inward/record.url?scp=85075777169&partnerID=8YFLogxK

U2 - 10.1093/rheumatology/kez409

DO - 10.1093/rheumatology/kez409

M3 - Article

C2 - 31580449

AN - SCOPUS:85075777169

VL - 59

SP - 1296

EP - 1305

JO - Rheumatology

JF - Rheumatology

SN - 1462-0324

IS - 6

ER -

View graph of relations

© 2018 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454