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Patients with rheumatoid arthritis are at increased risk for lower GI problems

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Patients with rheumatoid arthritis are at greater risk for lower gastrointestinal problems such as ulcers, bleeding and perforations, according to researchers from the Mayo Clinic. The findings also show those patients with rheumatoid arthritis (RA) are also at greater risk for gastrointestinal (GI)-related death than those without the disease.

In a Mayo Clinic news release, the researchers noted their findings point out a need for new ways to prevent and treat lower GI disease in RA patients, as lower GI complications are on the increase even as upper GI complications have decreased significantly.

“What we are seeing for the first time in a systematic way is that patients with [RA] are also at risk for problems of bleeding and ulcers in the lower gut, especially the colon,” study co-author Eric Matteson, MD, stated in the release.

According to the study abstract, Matteson and his team analyzed a cohort of 813 patients with RA whose condition was confirmed between 1980 and 2008, as well as an 813-patient cohort of individuals without RA. Mean follow-up was greater than 10 years for both groups.

Matteson and his team reported a rate of upper GI events per 100 person-years of 2.9 in patients with RA vs. 1.7 in those patients without RA. Rates of lower GI events were 2.1 in the RA group and 1.4 in the non-RA group. However, while the rate of upper GI events in RA patients declined over the 28-year study period, the rate of lower GI events remained the same.

The researchers found that prior upper GI disease or abdominal surgery, use of glucocorticoids and smoking were all associated with lower GI events in patients with RA. Upper and lower GI events were both associated with increased mortality risk in patients with RA.

Reference:

• Myasoedova E, Matteson EL, Talley NJ, Crowson CS. Increased incidence and impact of upper and lower gastrointestinal events in patients with rheumatoid arthritis in Olmsted County, Minnesota: A longitudinal population-based study. J Rheum. 2012. doi: 10.3899/jrheum.111311