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Radner H et al. – Physical disability is worsening with increasing level of comorbidity, irrespective of disease activity.

Methods

Prospective cohort study
Ascertained age adjusted Charlson comorbidity index (CCIA), as well as serial measurements of disease activity and functional disability (evaluated by the Health Assessment Questionnaire Disability Index, HAQ)
380 patients with established RA seen at outpatient clinic over one year (June 2007 to July 2008)

Results

Defined 4 patient groups with increasing levels of comorbidity
Mean HAQ scores significantly different across these groups (0.67, 0.80, 1.24, 1.40, respectively) also when adjusted for disease activity, gender and disease duration in regression model (0.84, 0.88, 1.14, 1.48, respectively)
CCIA effects on disability similar within different strata of disease activity, namely remission ; low disease activity ; and moderate to high disease activity and thus independent of disease activity
Several sensitivity analyses, including use of SF-36, confirmed observations

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