Comorbid conditions in patients with rheumatic diseases: an update

Abstract

Purpose of review: This review summarizes recent literature (September 2002 to September 2003) on three comorbid conditions (infection, cardiovascular disease, and malignancy) in patients with rheumatic disease.

Recent findings: Infection risk in rheumatoid arthritis is increased as a result of treatment and the disease itself. Atherosclerotic cardiovascular events are increased in rheumatoid arthritis. Although cardiovascular events also are increased in lupus, screening for cardiovascular risk factors in these patients is suboptimal. The incidence of malignancy overall and specifically the incidence of lymphoma are not increased in patients with rheumatoid arthritis on antitumor necrosis factor therapy compared with patients with rheumatoid arthritis in general.

Summary: Rheumatologists must be aware of the risk of infection, atherosclerotic events, and cancers in their patients. As prognosis for rheumatic disease patients continues to improve, the impact of comorbid conditions on morbidity and mortality is more apparent. Further research is needed to elucidate the relative contributions of the underlying autoimmune diseases and their treatments on these conditions that affect long-term patient survival.