SAT0061 Prevalence of Co-Morbidities in Rheumatoid Arthritis (RA) and Evaluation of their Monitoring: Results of an International, Cross-Sectional Study (Comora)

Background Increased risk of cardio-vascular disease, infection and osteoporosis is well documented in RA. Some of these co-morbidities (e.g. cardiovascular disease risk) are subject to recommendations, with specific components relevant to RA. It is unclear whether such co-morbidity is recognized, or whether recommendations are applied in practice. Objectives To evaluate: 1) the prevalence of RA co-morbidities in different countries worldwide and 2) the gap between available recommendations and daily practice concerning prevention/management of such co-morbidities. Methods International, cross-sectional study of consecutive RA patients in routine care. Data comprise RA characteristics, plus relevant cardiovascular, infection, cancer, gastro-intestinal pulmonary, psychiatric disorders. Results Seventeen participating countries (from 4 continents) included 4586 patients. Age: 56+13 years, disease duration: 10+9 years, female gender: 82%, DAS28-ESR: 3.7 + 1.6, HAQ1.0+0.7, any past or current intake of methotrexate (98%), of biotherapy (39%). The most frequent coincident diseases (past or current) were depression: 15%, asthma 6.6%, cardiovascular events (myocardial infarction, stroke) 6%, solid cancer (excluding basocellular carcinoma) 4.5%, and chronic obstructive pulmonary disease 3.5%. Substantial inter-country variability was observed both for prevalence of co-morbidities or coincident conditions [(e.g.% smokers from 3% (Morocco) to 48% (Austria), % with hepatitis (from 0% (France) to 7% (Egypt)] and also for the prevention/management of co-morbidities (e.g. pneumococcal vaccination from 0% (Netherlands) to 87% (Germany). Critically, systematic evaluation of co-morbidities permitted detection of previously undetected abnormalities [e.g. elevated blood pressure (11.2%), hyperglycemia (5.8%)] and serving to emphasise the sub-optimal management of such co-morbidities (e.g. of 236 patients with a history of cardiovascular events, 74 (32%) were not on anti-thrombotic therapy). Conclusions This study suggests a) high prevalence of co-morbidities in RA, b) substantial inter-country variability c) variable detection of relevant risk factors and application of preventive strategies (e.g. vaccination). The study strongly suggests that rigorous application of systematic evaluation of co-morbidities could permit earlier detection and disciplined management with attendant improvement in outcomes in RA. Acknowledgements This study was conducted thanks to an unrestricted