A Mayo Clinic-led study centering on 3,276 patients discovered that people with inflammatory bowel disease, Type 1 diabetes or blood clots may face higher risks for developing rheumatoid arthritis and rheumatoid arthritis patients face risk of developing heart disease, blood clots and sleep apnea.
The study, published in Mayo Clinic Proceedings reveals a growing number of risks for rheumatoid arthritis patients associated with comorbidities.
The study identified 821 patients with rheumatoid arthritis who were diagnosed at Mayo Clinic in Minnesota and Florida between January 2009 and February 2018, and enlisted 2,455 control participants, for a total sample of 3,276 participants. Researchers found that 11 comorbidities were associated with rheumatoid arthritis, including epilepsy and pulmonary fibrosis.
Comorbidities Accumulate in Accelerated Fashion
Among other new information in the study, blood clots occurred more commonly in rheumatoid arthritis cases before diagnosis, suggesting that systemic inflammation may start before the rheumatoid arthritis symptoms become clinically apparent. The association with Type 1 diabetes prior to diagnosis of rheumatoid arthritis also was strong, highlighting the importance of heightened suspicion of rheumatoid arthritis in patients with autoimmune diseases, and vice versa.
“Our findings suggest that people with certain conditions, such as Type 1 diabetes or inflammatory bowel disease, should be carefully monitored for rheumatoid arthritis,” says Dr. Vanessa Kronzer, a clinician investigator fellow in rheumatology at Mayo Clinic and the study’s corresponding author. “In addition, people who have rheumatoid arthritis, and their health care providers, should have heightened suspicion and a low threshold to screen for cardiovascular disease, blood clots and sleep apnea.”
Dr. Krozner continued: “We found that comorbidities accumulate in an accelerated fashion after diagnosis of rheumatoid arthritis,” says Vanessa Kronzer, M.D., a clinician investigator fellow in rheumatology at Mayo Clinic and the study’s corresponding author. “We also found that autoimmune diseases and epilepsy may predispose to development of rheumatoid arthritis, while heart disease and other conditions may develop as a result of rheumatoid arthritis.”
The Mayo Clinic Biobank
The Mayo Clinic Biobank was used for this study. A valuable collection of samples, including blood and blood derivatives—as well as additional health information—all donated by Mayo Clinic patients and other volunteers. It offers notable value for research including depth of self-reported health information gathered, including an extensive list of comorbidities. In fact, the biobank contains data on 74 comorbidities and the age of onset for these comorbidities.
Funding & Interests
The study was funded by a Rheumatology Research Foundation Resident Research Preceptorship and K Supplement Award and the grants from the National Arthritis Institute of Arthritis and Musculoskeletal and Skin Diseases. No competing interests were reported among the study leads.
Call to Action: If you or a loved one have been diagnosed with rheumatoid arthritis, consider the implications of the study findings—additionally for those that have been diagnosed with the other diseases mentioned they could be at greater risk of RA. The data isn’t conclusive but it surely uncovers what appear to be associations.