Background/Purpose: Patients with inflammatory arthritis (IA), including rheumatoid arthritis (RA) and spondyloarthritis (SpA), are at elevated risk for comorbidities, complicating disease management. Despite rheumatology societies recommending periodic comorbidity reviews, their integration into routine care remains challenging. This study aimed to (i) assess baseline compliance with comorbidity management recommendations among patients with IA, and (ii) identify clinical action items resulting from a physician-led global review.

Methods: We conducted a retrospective cohort study of adults with RA or SpA who underwent a standardized global review at Hôpital Cochin, Paris, between June 2017 and March 2025. The review adhered to EULAR recommendations for comorbidity management in rheumatic diseases and included assessments for cardiovascular risk, bone health, infections, and malignancy (1). Descriptive statistics were used to summarize patient characteristics and actions taken.

Results: The cohort included 458 patients (RA: 187, SpA: 271) with a mean disease duration of 17.4 years (SD 12.9) as detailed in Table 1. Among RA patients, 84.5% were female, with a mean age of 55.0 years (SD 15.4) and mean DAS28 of 2.7 (SD 1.3). Among SpA patients, 42.8% were female, mean age 48.6 years (SD 13.3), and mean ASDAS 1.8 (SD 1.0). Among all patients, corticosteroids were used by 14.7%, and biologics by 63.1%. Cardiovascular history included ischaemic heart disease in 3.5%, diabetes in 4.8%, and hypertension in 22.5% of the total population, with comparable rates across the RA and SpA subgroups. Active smoking was reported in 19.3% of RA and 24.0% of SpA patients. LDL levels were above target in 40.5% and 47.5%, and obesity (BMI >30 kg/m²) affected 10.9% and 13.8% in RA and SpA patients, respectively. New cardiology referrals were initiated for 25 (5.6%) patients due to high ischaemic risk as seen in Table 2. Regarding bone health, vitamin D deficiency was present in 75.1% of the overall population. Fractures were reported in 14.4% of RA patients and 6.7% of SpA patients, while a DXA-based definition of osteoporosis was seen in 18.2% vs. 15.5% respectively. In terms of vaccination coverage, adherence was 54.0% for influenza, 53.4% for pneumococcal, and 55.7% for diphtheria-tetanus-polio (DTP) vaccines, as per French recommendations. The global review led to a vaccine prescription in 62.5% of cases. Malignancy screening adherence was 48.0% for colon, 39.4% for skin, 83.6% for breast, and 87.2% for cervical cancer.

Conclusion: Our findings underscore the gap between recommended and actual comorbidity management in IA. The global review revealed areas needing intervention and generated actionable steps to address care gaps. Importantly, this model demonstrates that systematic screening can be feasibly implemented in routine rheumatology clinical practice.Reference: 1. Baillet A, et al. Points to consider for reporting, screening for and preventing selected comorbidities in chronic inflammatory rheumatic diseases in daily practice: a EULAR initiative. Annals of the rheumatic diseases. 2016 Jun 1;75(6):965-73.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/systematic-comorbidity-screening-in-inflammatory-arthritis-the-experience-of-a-tertiary-care-centre/