Application of the 2015/2016 EULAR recommendations for cardiovascular risk in daily practice: data from an observational study

International audienc

Relevance and feasibility of a systematic screening of multimorbidities in patients with chronic inflammatory rheumatic diseases

International audienceObjectives: EULAR recently proposed to screen multimorbidities in chronic inflammatory rheumatic diseases. The aims of the study were to define the most common multimorbidities in chronic inflammatory rheumatic diseases, compare the screening approach performed in the clinic with the recent EULAR recommendations, validate the points to consider for the systematic standardized multimorbidity screening proposed by EULAR and assess feasibility of such a screening in a daily clinic.Methods: Data were collected prospectively during a 1-day multimorbidity clinic. Diabetes, hypertension, CVD damage, chronic respiratory diseases, osteoporosis and preventive measures were assessed. The comparison with EULAR points to consider was performed retrospectively.Results: We included 200 consecutive patients (157 with rheumatoid arthritis, 37 spondyloarthritis, and 6 connective tissue diseases or vasculitis). The most common multimorbidities already diagnosed in our patients were hypertension (26%) and diabetes (7.5%). Screening showed that 61.5% (CI95%: 54.6%-67.9%) patients presented at least one undiagnosed or uncontrolled diseases: diabetes (6%), hypertension (20.6%), dyslipidemia (16.1%) valvulopathies (16.8%), peripheral artery disease (4.5%); carotid stenosis (6.5%) and aortic aneurysm (5.5%). Overall, 39.9% patients had incomplete cancer screening and 52.8% incomplete vaccine schedule. Undiagnosed pulmonary obstruction and risk of sleep apnea were suspected in 15.5% and 40.1% patients, respectively.Conclusion: This study underlines the relevance of a systematic screening of multimorbidities in chronic inflammatory rheumatic diseases and its feasibility in a 1-day clinic. Spirometry and sleep apnea screening should be added to EULAR points to consider. The long-term impact of such screening needs to be evaluated

Daily nutrient intake in patients with early RA and matched controls.

<p>Daily nutrient intake in patients with early RA and matched controls.</p

Sodium excretion was higher in early RA patients with erosions than in those without.

<p>Horizontal bars are median and whiskers are IQR compared by Mann-Whitney test.</p

Baseline characteristics of patients with RA at diagnosis (early RA) and matched controls.

<p>Baseline characteristics of patients with RA at diagnosis (early RA) and matched controls.</p

Sodium excretion was higher in patients with early RA than in matched controls.

<p>Sodium intake was assessed by 24-hr urinary sodium excretion. Horizontal bars are means and whiskers are SEM. Student <i>t</i> test was used.</p

Multi-adjusted analysis of sodium excretion in early RA and matched controls.

<p>Multi-adjusted analysis of sodium excretion in early RA and matched controls.</p