IBD, type I diabetes may predispose individuals to RA

Findings from a time-dependent analysis of comorbidities in patients with rheumatoid arthritis and healthy controls suggest that inflammatory bowel disease and type I diabetes may predispose individuals to RA, according to recent data presented at the EULAR Annual Congress.

Vanessa Kronzer, MD, of the Mayo Clinic School of Graduate Medical Education in Rochester, Minnesota, and colleagues investigated 821 patients with RA who were matched with three controls each.

The researchers compared the prevalence of 77 comorbidities in the RA and non-RA populations. They also looked at time associations for comorbidity development in relation to RA onset. The aim was to determine which comorbidities might predispose individuals to RA, and which might result from RA.
Before RA diagnosis, both the RA and non-RA groups had a median of 1comorbidity (P = .49). However, by the time of the survey, RA patients had a median of five comorbidities, compared with four in the non-RA group (P < .001).

Findings from a time-dependent analysis of comorbidities in patients with rheumatoid arthritis and healthy controls suggest that IBD and type I diabetes may predispose individuals to RA, according to recent data.

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Also at the time of the survey, a host of comorbidities were more common in the RA group, including osteoarthritis (P < .001), fibromyalgia (P < .001), autoimmune disorders (P < .001), myocardial infarction (P < .001), COPD (P < .001), sleep apnea (P < .001), pulmonary fibrosis (P < .001), GERD (P < .001), IBD (P < .001), epilepsy (P = .003) and cataracts (P = .003).

Cancer incidence was 31% in the RA population and 32% in the non-RA population (P = .8).

The researchers noted two comorbidities that were likely to develop before RA diagnosis in patients with RA, compared with controls: IBD (1.9% vs. 0.5%; P < .001) and type 1 diabetes (1.3% vs. 0.4%; P = .01).

“While it is common for patients to have both type 1 diabetes and rheumatoid arthritis, our results suggest that inflammatory bowel disease and type 1 diabetes may predispose to rheumatoid arthritis development, which merits further study,” Kronzer said in a press release.

Conversely, after RA diagnosis, individuals in the patient group were more likely to experience myocardial infarction: 3.8% vs. 1.2% (P < .001). In addition, following RA diagnosis, hyperlipidemia was less common in patients than controls: 11.4% vs. 16.4% (P = .004).

“The increased occurrence of inflammatory bowel disease and type 1 diabetes prior to RA suggests either a predisposition to RA development or a shared immunological defect, meriting further study,” the researchers concluded.

“These results are important because understanding the timeline of comorbidity development in patients with rheumatoid arthritis will inform our knowledge of the disease progression and help identify targets for improving outcomes,” Hans Bijlsma, MD, professor of rheumatology at the University of Amsterdam and EULAR President, added in a press release. – by Rob Volansky

Reference:

Kronzer V, et al. OP0088. Presented at: EULAR Annual Congress; June 12-15, 2019; Madrid.

Disclosure: Kronzer reports no relevant financial disclosures.