Background/Purpose: Many people with inflammatory arthritis live with other serious chronic conditions that may affect their quality of life and ability to effectively manage their rheumatic condition. To better understand the comorbidities people with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA) live with, we surveyed people with those conditions about their coexisting chronic conditions.

Methods: Patients from the Global Healthy Living Foundation’s patient communities (the PatientSpot research registry, CreakyJoints, and the Patient Support Program) were invited to participate in a short, cross-sectional survey about their comorbidities. Specifically, we asked about other autoimmune conditions, skin or dermatologic conditions, endocrine or metabolic conditions, and lung or pulmonary conditions, totaling 60 choices plus the option to write in responses. Diagnoses provided were self-reported. Demographic information was not captured in the survey, designed as five simple questions to maximize participation, but was available for PatientSpot members at registration. Results from participants (pts) with RA, PsA, and axSpA (including ankylosing spondylitis and non-radiographic axSpA) were analyzed descriptively. Results for only the top 10 comorbidities for each inflammatory arthritis diagnosis are provided.

Results: A total of 1,960 pts with inflammatory arthritis completed the survey, with 1,207 reporting a diagnosis of RA, 534 of PsA, and 219 of axSpA. Among the pts with demographic data (31.5%), the mean (SD) age was 56.3 (12.5), 84.3% were female, and 90.4% were white (Table 1). Top comorbidities among pts with RA were osteoarthritis (52.0%), osteoporosis (28.4%), fibromyalgia (26.8%), obesity (24.6%) and asthma (23.6%) (Table 2). Top comorbidities with PsA were psoriasis (66.1%), osteoarthritis (51.3%), obesity (34.3%), fibromyalgia (28.1%), and asthma (26.8%). Top comorbidities with axSpA were osteoarthritis (51.6), asthma (30.6%), obesity (30.6%), fibromyalgia (25.6%), and osteoporosis (20.1%). Asthma, eczema, and obesity consistently appeared across the three conditions (Table 2). Notably, Sjogren’s syndrome was more prevalent with RA (18.1%) compared with PsA (10.5%) or axSpA (12.3%). Pts reported a mean (SD) of 3.2 (2.3) comorbidities and all pts with RA, PsA, or axSpA reported at least one concomitant condition. Pts with PsA reported more comorbidities, a mean of 3.7 (2.5), compared with those with RA (3.0 [2.2]) or axSpA (3.0 [2.2]).

Conclusion: Many of the most prevalent comorbidities reported by patients with inflammatory arthritis in this cohort are common and include osteoarthritis, fibromyalgia, and osteoporosis. Autoimmune conditions, such as asthma and eczema, may reflect broader immune dysregulation among these patients. Obesity, a top comorbidity across the three conditions, can be both a cause and an effect of worsened disease outcomes. Future research should be informed by specific comorbidity clusters, such as the combination of obesity, osteoarthritis, and fibromyalgia, to optimize therapeutic efficacy and patient outcomes.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/most-prevalent-self-reported-comorbidities-among-patients-with-rheumatoid-arthritis-psoriatic-arthritis-and-axial-spondyloarthritis/