Prevalence of Comorbidities and Poor Prognostic Factors Among Patients with Rheumatoid Arthritis in Bangladesh

Objective This study aimed to assess the prevalence of comorbidities among Rheumatoid arthritis (RA) patients and identify factors associated with it. Methods A cross-sectional study was conducted at 2-tertiary care hospitals among 653 patients with RA. Data on demographics, poor prognostic factors (high ESR, CRP, RF, anti-CCP antibody titres, and DAS28 > 5.1); and comorbidities were collected via a structured questionnaire and medical record review. Comorbidities were quantified via the Charlson Comorbidity Index (CCI). Logistic regressions were used to identify associated factors. Results A total of 643 (98.5%) patients had ≥1 comorbidity. The most prevalent were dyslipidemia (75.8%), obesity (58.7%), hypertension (42.7%), type 2 diabetes (30.3%), and osteoporosis (15.6%). Age ≥ 45 years was independently associated with coronary artery disease (OR 9.71, 95% CI 1.91–178.00), osteoporosis (OR 19.60, 95% CI 5.96–121.00) and infectious diseases (OR 1.6, 95% CI 1.03- 2.54). Male sex was associated with increased cardiovascular risk (female OR 0.27, 95% CI 0.11–0.62), whereas female sex was associated with increased odds of osteoporosis (OR 3.55, 95% CI 1.71–8.37) and gastrointestinal disorders (OR 2.18, 95% CI 1.37–3.56). The use of tsDMARDs and bDMARDs increased the risk of infection (ORs of 14.80 and 4.11, respectively). High DAS28-CRP and ESR values were linked to gastrointestinal comorbidities. The CCI survival index was significantly lower in older patients (≥45 years) (mean 68.7, SD 26.7) than in younger patients (mean 93.3, SD 6.7, p < 0.001). Conclusion Patients with RA in Bangladesh have high multimorbidity, particularly early CVD risk.