ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2238

Impact of Type 2 Diabetes on Cardiovascular and Renal Outcomes in Rheumatoid Arthritis: Insights from a Large-Scale Multi-Center Analysis

Godbless Ajenaghughrure1, Sila Mateo Faxas2, Gurjot Singh3, Nirys Mateo Faxas4, Kim Nguyen3, Nicole Tejeda5 and Kimberly Ramirez Bonetti6, 1Trihealth Good Samaritan Hospital, Cincinnati, OH, 2Good Samaritan Hospital, Cincinnati, OH, 3Trihealth Good Samaritan Hospital, Cincinnati, 4Independent Author, Santo Domingo, Dominican Republic, 5Independent Author, Cincinnati, 6Independent Author, cincinnati, OH

Meeting: ACR Convergence 2025

Keywords:

Session Information

Date: Tuesday, October 28, 2025

Title: (2227–2264) Rheumatoid Arthritis – Diagnosis, Manifestations, and Outcomes Poster III

Session Type: Poster Session C

Session Time: 10:30AM-12:30PM

Background/Purpose: Rheumatoid arthritis (RA) is associated with increased cardiovascular risk, but the additional impact of type 2 diabetes mellitus (T2DM) on the cardiorenal outcomes in this population remains insufficiently characterized. This study aimed to quantify the additional risk conferred by T2DM in RA patients for developing specific cardiovascular and renal complications.

Methods: We performed a retrospective cohort study using the TriNetX global federated health research network, comprising electronic health records from 100 healthcare organizations. We identified adult patients (18-99 years) with RA (ICD-10 M06.9), stratified by T2DM status (ICD-10 E11). After propensity score matching for demographic and clinical factors, 129,630 patients were included in each cohort. Patients were followed for up to 5 years to evaluate cardiorenal outcomes.

Results: RA patients with T2DM had significantly higher risk of acute kidney failure (HR 2.57, 95% CI 2.49-2.66, p < 0.001) compared to those without diabetes. The T2DM cohort also showed increased risk of heart failure (HR 1.93, 95% CI 1.86-1.96, p < 0.001), cerebral infarction (HR 1.67, 95% CI 1.60-1.75, p < 0.001), and pulmonary hypertension (HR 1.93, 95% CI 1.84-2.03, p < 0.001). Additionally, patients with both conditions demonstrated higher incidence of acute pulmonary edema (HR 1.93, 95% CI 1.84-2.03, p < 0.001) and sepsis (HR 2.57, 95% CI 2.49-2.66, p < 0.001). Mortality was significantly elevated in the comorbid group (HR 1.73, 95% CI 1.69-1.78, p < 0.001).

Conclusion: The coexistence of T2DM in RA patients substantially increases the risk of adverse cardiorenal outcomes and mortality. These findings emphasize the importance of early screening and aggressive management of cardiovascular and renal risk factors in RA patients with comorbid T2DM. Collaborative care models involving rheumatologists, endocrinologists, and cardiologists may be essential for optimal management of this high-risk population.

Disclosures: G. Ajenaghughrure: None; S. Mateo Faxas: None; G. Singh: None; N. Mateo Faxas: None; K. Nguyen: None; N. Tejeda: None; K. Ramirez Bonetti: None.

To cite this abstract in AMA style:

Ajenaghughrure G, Mateo Faxas S, Singh G, Mateo Faxas N, Nguyen K, Tejeda N, Ramirez Bonetti K. Impact of Type 2 Diabetes on Cardiovascular and Renal Outcomes in Rheumatoid Arthritis: Insights from a Large-Scale Multi-Center Analysis [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/impact-of-type-2-diabetes-on-cardiovascular-and-renal-outcomes-in-rheumatoid-arthritis-insights-from-a-large-scale-multi-center-analysis/. Accessed .

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