title: Co-morbidities in Finnish patients with rheumatoid arthritis: 15-year follow-up.
abstract: OBJECTIVE
  To study the prevalence and importance of co-morbidities in patients with rheumatoid arthritis (RA) at the time of the diagnosis and after a 15-year follow-up, focusing on the relationship between co-morbidity and disease activity.
  
  
  METHODS
  The study population comprised 87 patients with early RA (mean age 44 years, 79% female, and 65% rheumatoid factor positive) collected from the Helsinki area between 1986 and 1989. Data for co-morbidities were collected at baseline and at a 15-year examination or at the time of death, and the age-weighted Charlson co-morbidity index (CCIa) at baseline was calculated for each patient. The disease activity score based on 28 joints (DAS28) was assessed with three parameters at baseline and during the first year (DAS28 AUC0-12). The relationship between co-morbidity and activity of RA was studied in groups CCIa 0, CCIa 1-2, and CCIa ≥ 3.
  
  
  RESULTS
  Adequate data were available in 80 patients with a mean age of 60 years and a mean disease duration of 15.4 years. At baseline, 20% of patients had at least one co-morbid condition (CC). At endpoint, 60% of the patients had some co-morbidity: 34% had one CC, 19% two, 5% three, and 2% four CCs. The most common end-point CCs were hypertension (30%), cardiovascular diseases (14%), and malignancies (11%). DAS28 AUC0-12 and DAS28 at end-point were higher in groups CCIa1-2 and CCIa ≥ 3 than in CCIa 0.
  
  
  CONCLUSIONS
  Co-morbidities increased during the 15 years of RA and the patients with high baseline CCIa showed higher disease activity both in early disease and at end-point.
authors.affiliation: Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital , Helsinki , Finland.
authors.forename: T
authors.initials: T
authors.lastname: Tiippana-Kinnunen
authors.forename: H
authors.initials: H
authors.lastname: Kautiainen
authors.forename: L
authors.initials: L
authors.lastname: Paimela
authors.forename: M
authors.initials: M
authors.lastname: Leirisalo-Repo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents