Comorbidity Burden in Rheumatic Diseases

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Background

In this new era of stratified medicine, there is a growing need to deliver more tailored patient care that better suits an individual’s specific circumstances. This is particularly relevant in chronic rheumatic diseases which are the commonest causes of word-wide disability, and which often require strong immunosuppressive therapies. Understanding the wider patient and disease characteristics in this group of patients is therefore fundamental in modern rheumatology practice.

The presence and relevance of co-existing conditions (comorbidities) in rheumatic diseases is an area that has gained interest in recent years. Emerging evidence suggests that comorbidities prevent the achievement of treat-to-target goals and consequently negatively impact on disease outcomes. However, there is a general gap in literature on the presence and impact of comorbidities in rheumatic diseases which partly stems from the failure or variation in capturing this type of data. This necessitates the closer study of this topic and has become the focus of European-wide initiatives and task forces to harmonize comorbidity data collection in rheumatic diseases. Practical methods of measuring and recording, as well as optimal ways of managing comorbidities in rheumatic diseases, is crucial in clinical practice. The latter is exemplified by the well-known independent influence of rheumatoid arthritis (RA) on adverse cardiovascular outcomes. Furthermore, recent evidence suggests that the burden of comorbidity on presentation of RA has risen over time, highlighting the need for better screening, monitoring and treating comorbidities.

The proposed research topic aims to address the gap in literature on the nature, occurrence and impact of comorbidities in rheumatic diseases as well as practical aspects relating to measuring and recording comorbidities. We propose a series of manuscripts focusing on three key domains: i) a review of existing ‘instruments’ or indices for measuring comorbidity and their value in routine clinical practice; ii) the prevalence of comorbidities in common rheumatic diseases; iii) the association between comorbidities and important disease outcomes. We envisage that this work will include a number of manuscripts ranging from systematic literature reviews through to methodology/process development manuscripts and original research work on the subject.

Keywords: Comorbidity, rheumatic diseases

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