Peculiarities of the course of rheumatoid arthritis in patients with thrombocytosis and comorbid conditions

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Resumo

Rheumatoid arthritis (RA) is a disease with a wide comorbid background, with the most common and socially significant being cardiovascular disease, which is the main cause of mortality.

Aim: to estimate and compare comorbidity profile in groups of RA patients with and without thrombocytosis.

Material and methods. The study enrolled 240 patients with RA, of whom 120 patients with normal thrombocytosis and 120 with thrombocytosis. Laboratory tests included assessment of the levels of RF, ACPA, ESR, CRP, ferritin, TPO, IL-6, soluble P-selectin. RA activity was determined by DAS28, instrumental examination consisted in determination of radiological stage of hand and foot lesions according to Steinbroecker, besides, the frequency of comorbid pathology was evaluated.

Results. The levels of ESR, CRP, IL-6, TPO-ferritin, RF and median values of DAS28 activity by ESR and CRP were significantly higher in subjects with RA and thrombocytosis compared to patients with normal level of platelets. There were also differences in the incidence of radiological stages I and III. In turn, in patients with thrombocytosis, the incidence of some comorbidities was significantly higher.

Conclusion. RA patients with thrombocytosis have higher clinical and laboratory activity as well as radiological progression of the disease in comparison with RA patients without thrombocytosis. These peculiarities of the course of RA require more intensive treatment. Besides, wide range of comorbid pathology is more frequent in the group of RA patients with thrombocytosis and this fact should be taken into consideration in real clinical practice.

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Sobre autores

Vadim Mazurov

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatology Hospital No. 25

Autor responsável pela correspondência
Email: maz.nwgmu@yandex.ru
ORCID ID: 0000-0002-0797-2051

MD, professor, academician of RAS, Chief scientific consultant, director, head of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, head of the Center for autoimmune diseases, Honored Worker of Science of the Russian Federation

Rússia, Saint Petersburg; 190068, Saint Petersburg, 30 Bol`shaya Pod`yacheskaya Str.

Evgeny Melnikov

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatology Hospital No. 25

Email: melnikovzhenya@mail.ru
ORCID ID: 0000-0002-8521-6542

postgraduate student at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, rheumatologist

Rússia, Saint Petersburg; 190068, Saint Petersburg, 30 Bol`shaya Pod`yacheskaya Str.

Kira Morozova

Clinical Rheumatology Hospital No. 25

Email: kiramorozoba@mail.ru
ORCID ID: 0000-0002-4113-3104

rheumatologist

Rússia, 190068, Saint Petersburg, 30 Bol`shaya Pod`yacheskaya Str.

Victoria Evgrafova

Inlab Genetics LLC

Email: Tinakonan@mail.ru
ORCID ID: 0000-0002-7050-6838

laboratory assistant

Rússia, 192019, Saint Petersburg, 37 Sedova Str.

Bibliografia

  1. Клиническая ревматология. Руководство для врачей. 3-е издание, переработанное и дополненное. Под ред. В.И. Мазурова. М.: Е-ното. 2021; 696 с. [Clinical rheumatology. Guide for doctors. 3rd edition, revised and enlarged. Ed. by Mazurov V.I. Moscow: E-noto. 2021; 696 pp. (In Russ.)]. ISBN: 978-5-906023-26-1.
  2. Мазуров В.И. Мельников Е.С. Башкинов Р.А. Влияние тромбоцитов на течение ревматоидного артрита и сердечно-сосудистый риск. Терапия. 2021; 7(10): 78–88. [Mazurov V.I., Melnikov E.S., Bashkinov R.A. Effect of platelets on the course of rheumatoid arthritis and cardiovascular risk. Terapiya = Therapy. 2021; 7(10): 78–88 (In Russ.)]. https://dx.doi.org/10.18565/therapy.2021.10.78-88. EDN IFQACV.
  3. England B.R., Thiele G.M., Anderson D.R., Mikuls T.R. Increased cardiovascular risk in rheumatoid arthritis: Mechanisms and implications. BMJ. 2018; 361: k1036. https://dx.doi.org/10.1136/bmj.k1036.
  4. Peters M.J., Symmons D.P., McCarey D. et al. EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis. Ann Rheum Dis. 2010; 69(2): 325–31. https://dx.doi.org/10.1136/ard.2009.113696.
  5. Liao K.P. Cardiovascular disease in patients with rheumatoid arthritis. Trends Cardiovasc Med. 2017; 27(2): 136–40. https://dx.doi.org/10.1016/j.tcm.2016.07.006.
  6. Agca R., Hopman L.H.G.A., Laan K.J.C. et al. Cardiovascular event risk in rheumatoid arthritis compared with type 2 diabetes: A 15-year longitudinal study. J Rheumatol. 2020; 47(3): 316–24. https://dx.doi.org/10.3899/jrheum.180726.
  7. Ogdie A., Yu Y., Haynes K. et al. Risk of major cardiovascular events in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a population-based cohort study. Ann Rheum Dis. 2015; 74(2): 326–32. https://dx.doi.org/10.1136/annrheumdis-2014-205675.
  8. Cooksey R., Brophy S., Kennedy J. et al. Cardiovascular risk factors predicting cardiac events are different in patients with rheumatoid arthritis, psoriatic arthritis, and psoriasis. Semin Arthritis Rheum. 2018; 48(3): 367–73. https://dx.doi.org/10.1016/j.semarthrit.2018.03.005.
  9. Pujades-Rodriguez M., Duyx B., Thomas S.L. et al. Rheumatoid arthritis and incidence of twelve initial presentations of cardiovascular disease: A population record-linkage cohort study in England. PLoS One. 2016; 11(3): e0151245. https://dx.doi.org/10.1371/journal.pone.0151245.
  10. Сарсенбаева Г.И., Турсынбекова А.Е. Современные подходы к оценке коморбидности у пациентов. CardioСоматика. 2019; 10(1): 19–23. [Sarsenbayeva G.I., Tursynbekova A.E. Modern approaches to the assessment of comorbidity in patients. CardioSomatika = CardioSomatics. 2019; 10(1): 19–23 (In Russ.)]. https://dx.doi.org/10.26442/22217185.2019.1.180073. EDN: MFNTTC.
  11. Campbell-Scherer D. Multimorbidity challenge ofevidence-based medicine. Evid Based Med. 2010; 15(6): 165–66. https://dx.doi.org/10.1136/ebm1154.
  12. Верткин А.Л., Румянцев М.А., Скотников А.С. Коморбидность в клинической практике. Часть 1. Архивъ внутренней медицины. 2011; (1): 9–13. [Vertkin A.L., Rumiantsev M.A., Skotnikov A.S. Comorbidity in clinical practice. Part 1. Arkhiv vnutrenney meditsiny = The Russian Archives of Internal Medicine. 2011; (1): 9–13 (In Russ.)]. EDN: RPELQL.
  13. Pope J.E., Choy E.H. C-reactive protein and implications in rheumatoid arthritis and associated comorbidities. Semin Arthritis Rheum. 2021; 51(1): 219–29. https://dx.doi.org/10.1016/j.semarthrit.2020.11.005.
  14. Kannayiram S.S., Guraya A., Muojieje C.C. et al. An analysis of rheumatoid arthritis hospitalizations. Cureus. 2020; 12(12): e12344. https://dx.doi.org/10.7759/cureus.12344.
  15. Boers M., Hartman L., Opris-Belinski D. et al. Low dose, add-on prednisolone in patients with rheumatoid arthritis aged 65+: The pragmatic randomised, double-blind placebo-controlled GLORIA trial. Ann Rheum Dis. 2022; 81(7): 925–36. https://dx.doi.org/10.1136/annrheumdis-2021-221957.
  16. Roubille C., Richer V., Starnino T. et al. The effects of tumour necrosis factor inhibitors, methotrexate, non-steroidal anti-inflammatory drugs and corticosteroids on cardiovascular events in rheumatoid arthritis, psoriasis and psoriatic arthritis: a systematic review and meta-analysis. Ann Rheum Dis. 2015; 74(3): 480–89.

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