Objectives To investigate the association between risk of different co-morbidities and diagnosis of rheumatoid arthritis (RA) using a temporal approach. Methods Retrospective, case-control study. Data were extracted from all healthcare claims for Poland between 2011-2021. Prevalent RA(n = 262 265) patients were examined to evaluate morbidity patterns. Incident RA(n = 15 879) and age-, sex- and region-matched controls were sampled 1:10 from the general population (GP). Exposure was new-onset RA identified by interspaced, repeat claims and prescription. Follow-up was performed in a bidirectional, five-year timeframe from RA diagnosis(Dx). Results RA is associated with enhanced risk of multiple organ system disorders both pre- and post-Dx, especially hematologic (IRR 1.80, 95% CI 1.58, 2.05), pulmonary (IRR 1.57, 95% CI 1.53, 1.62), gastrointestinal (IRR 1.53, 95% CI 1.46, 1.60), and cardiovascular (IRR 1.25, 95% CI 1.22, 1.27) conditions. RA appears strongly associated with interstitial lung disease (pre-Dx IRR 2.97, 95% CI 2.20, 4.02; post-Dx IRR 4.66, 95% CI 3.91, 5.56) and inflammatory bowel disease (pre-Dx IRR 1.61, 95% CI 1.25, 2.07; post-Dx IRR 2.12, 95% CI 1.70, 2.63). Enhanced post-Dx risk of thyroid cancer (IRR 1.29, 95% CI 1.00, 1.66) and lymphoma (IRR 1.50, 95% CI 1.20, 1.88) was observed, in contrast to reduced risk of colon cancer (IRR 0.77, 95% CI 0.62, 0.94). Conclusion Enhanced risk of multiple comorbidities was observed both pre- and post-RA Dx, with varying patterns across different organ systems. These data highlight the multisystem nature of RA and warrant research into causal, bidirectional relationships.

中文翻译：

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类风湿性关节炎的合并症 — 一项具有双向随访的全国性病例对照研究


目的 使用时间方法探讨不同合并症风险与类风湿性关节炎 （RA） 诊断之间的相关性。方法 回顾性、病例对照研究。数据提取自 2011 年至 2021 年间波兰的所有医疗保健索赔。检查患病率 RA （n = 262 265） 患者以评估发病率模式。事件 RA （n = 15 879） 和年龄、性别和地区匹配的对照以 1：10 的比例从普通人群 （GP） 中抽样。暴露是通过间隔、重复索赔和处方确定的新发 RA。在 RA 诊断 （Dx） 后的双向五年时间范围内进行随访。结果 RA 与 Dx 前后多器官系统疾病的风险增加相关，尤其是血液学 （IRR 1.80， 95% CI 1.58， 2.05）、肺部 （IRR 1.57， 95% CI 1.53， 1.62）、胃肠道 （IRR 1.53， 95% CI 1.46， 1.60） 和心血管 （IRR 1.25， 95% CI 1.22， 1.27） 疾病。RA 似乎与间质性肺病 （Dx 前 IRR 2.97， 95% CI 2.20， 4.02;Dx 后 IRR 4.66， 95% CI 3.91， 5.56） 和炎症性肠病 （Dx 前 IRR 1.61， 95% CI 1.25， 2.07;Dx 后 IRR 2.12， 95% CI 1.70， 2.63） 密切相关。观察到甲状腺癌 （IRR 1.29， 95% CI 1.00， 1.66） 和淋巴瘤 （IRR 1.50， 95% CI 1.20， 1.88） 的 Dx 后风险增加，而结肠癌风险降低 （IRR 0.77， 95% CI 0.62， 0.94）。结论 RA Dx 前后均观察到多种合并症的风险增加，不同器官系统的模式不同。这些数据突出了 RA 的多系统性质，并需要对因果、双向关系进行研究。