Prevalence of comorbidities in systemic sclerosis versus rheumatoid arthritis: a comparative,multicenter, matched-cohort study |
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| Authors: | Stylianos Panopoulos Maria Tektonidou Alexandros A Drosos Stamatis-Nick Liossis Theodoros Dimitroulas Alexandros Garyfallos Lazaros Sakkas Dimitrios Boumpas Paraskevi V Voulgari Dimitrios Daoussis Konstantinos Thomas Georgios Georgiopoulos Georgios Vosvotekas Dimitrios Vassilopoulos Petros P Sfikakis |
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| Institution: | 1.Joint Rheumatology Program, 1st Department of Propedeutic Internal Medicine-Rheumatology Unit,National and Kapodistrian University of Athens, School of Medicine, Laikon General Hospital,Athens,Greece;2.Rheumatology Clinic, Department of Internal Medicine,Medical School University of Ioannina,Ioannina,Greece;3.Division of Rheumatology,University of Patras Medical School, Patras University Hospital,Patras,Greece;4.4th Department of Medicine,Aristotle University,Thessaloniki,Greece;5.Department of Rheumatology and Clinical Immunology, School of Health Sciences,University of Thessaly,Larissa,Greece;6.Joint Rheumatology Program, 4th Department of Medicine,National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital,Athens,Greece;7.Joint Rheumatology Program, Clinical Immunology-Rheumatology Unit, 2nd Department of Medicine and Laboratory,National and Kapodistrian University of Athens, School of Medicine, Hippokration General Hospital,Athens,Greece;8.1st Department of Medicine,Aristotle University of Thessaloniki, School of Medicine, University General Hospital of Thessaloniki AHEPA,Thessaloniki,Greece |
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| Abstract: | BackgroundComorbidities are common in chronic systemic connective tissue diseases and are associated with adverse outcomes, increased morbidity and mortality. Although the prevalence of comorbidities has been well-studied in isolated diseases, comparative studies between different autoimmune diseases are limited. In this study, we compared the prevalence of common comorbidities between patients with systemic sclerosis (SSc) and patients with rheumatoid arthritis (RA).MethodsBetween 2016 and 2017, 408 consecutive patients with SSc, aged 59?±?13?years (87% women), were matched 1:1 for age and gender with 408 patients with RA; mean disease duration was 10?±?8 and 9?±?8?years, respectively. Rates of cardiovascular risk factors, coronary artery disease, stroke, chronic obstructive pulmonary disease (COPD), osteoporosis, neoplasms and depression were compared between the two cohorts.ResultsThe prevalence of dyslipidemia (18.4% vs 30.1%, p?=?0.001) and diabetes mellitus (5.6% vs 11.8%, p?=?0.007) and body mass index (p?=?0.001) were lower in SSc compared to RA, while there was no difference in arterial hypertension or smoking. While there was a trend for lower prevalence of ischemic stroke in SSc than in RA (1.1% vs 3.2%, p?=?0.085), coronary artery disease was comparable (2.7% vs 3.7%). No differences were found between patients with SSc and patients with RA in the prevalence of COPD (5.2% vs 3.7%), osteoporosis (24% vs 22%) or neoplasms overall (1.1% vs 1.7%); however lung cancer was the most prevalent cancer in SSc (7/17, 41%), whereas hematologic malignancies (7/19, 36%) and breast cancer (7/19, 36%) predominated in RA. Depression was more prevalent in SSc (22% vs 12%, p?=?0.001), especially in diffuse SSc.ConclusionsDespite the prevalence of dyslipidemia and diabetes mellitus in SSc being almost half that in RA, the cardiovascular comorbidity burden appears to be similar in both. The overall prevalence of neoplasms is no higher in SSc than in RA, but SSc has a more negative impact on quality of life, as clearly, more SSc patients develop depression compared to patients with RA. |
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