Patients with Rheumatoid Arthritis (RA) have a higher prevalence of comorbidities compared to the general population. However, the implications of multimorbidity on therapeutic response and treatment retention remain unexplored. Objectives: (a) To evaluate the impact of multimorbidity on the effectiveness of the first targeted synthetic or biologic disease-modifying antirheumatic drug (ts/bDMARD), in patients with RA after 2-year follow-up; (b) to investigate the influence of multimorbidity on treatment retention rate. Patients with RA from the BIOBADASER registry exposed to a first ts/bDMARDs were included. Patients were categorized based on multimorbidity status at baseline, defined as a Charlson Comorbidity index (CCI) score ≥ 3. A linear regression model, adjusted for sex and age, was employed to compare the absolute DAS28 score over time after ts/bDMARD initiation between the two groups. The Log-Rank test and Kaplan-Meier curve were used to compare the retention rates of the first ts/bDMARD between the groups. A total of 1128 patients initiating ts/bDMARD were included, with 107 (9.3%) exhibiting multimorbidity. The linear regression model showed significantly higher DAS28 (beta coefficient 0.33, 95%CI:0.07–0.58) over a two-year period in patients with multimorbidity, even after adjusting for age and sex. Finally, no differences in the ts/bDMARD retention rate were found between groups (median 6.94–6.96 years in CCI < 3 vs. 5.68–5.62 in CCI ≥ 3; p = 0.610). Multimorbidity in patients with RA was associated with greater DAS28 scores within the first two years after ts/bDMARD initiation, in comparison with patients without multimorbidity. A slightly shorter retention rate was found in patients with multimorbidity, although the difference was non-significant.

中文翻译：

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BIOBADASER 登记处的类风湿性关节炎患者随访两年后，多重病态对首次 ts/bDMARD 有效性和保留率的影响

与普通人群相比，类风湿性关节炎 (RA) 患者的合并症患病率更高。然而，多发病对治疗反应和治疗保留的影响仍有待探索。目标： (a) 在 2 年随访后，评估多发病对 RA 患者第一种靶向合成或生物疾病缓解抗风湿药 (ts/bDMARD) 有效性的影响；(b) 研究多重疾病对治疗保留率的影响。BIOBADASER 登记处首次暴露于 ts/bDMARD 的 RA 患者也被纳入其中。根据基线时的多病状态对患者进行分类，定义为查尔森合并症指数 (CCI) 评分≥ 3。采用根据性别和年龄进行调整的线性回归模型来比较 ts/bDMARD 开始后一段时间内的绝对 DAS28 评分两组。采用Log-Rank检验和Kaplan-Meier曲线比较组间首次ts/bDMARD的保留率。总共纳入了 1128 名开始 ts/bDMARD 的患者，其中 107 名（9.3%）表现出多种疾病。线性回归模型显示，即使在调整年龄和性别后，两年内患有多种疾病的患者的 DAS28 也显着升高（β 系数 0.33，95%CI：0.07-0.58）。最后，各组之间的 ts/bDMARD 保留率没有差异（CCI < 3 的中位时间为 6.94–6.96 年，CCI ≥ 3 的中位时间为 5.68–5.62；p = 0.610）。与没有多重病态的患者相比，RA 患者的多重病态与 ts/bDMARD 开始后头两年内较高的 DAS28 评分相关。患有多种疾病的患者的保留率稍低，但差异并不显着。