Comorbidity in rheumatoid arthritis: is there a relation with glucocorticoids?

Comorbidity is an important medical and social problem due to its increasing prevalence and increased risk of adverse outcomes. Rheumatoid arthritis (RA) is a disease that is often combined with pathology of internal organs, mostly with cardiovascular diseases. The increased risk of comorbidity in RA is associated not only with immune inflammation, but also with adverse effects of antirheumatic therapy. As clinical practice has shown, glucocorticoids (GC), used in immune-inflammatory rheumatic diseases, are the leading drugs that can impact on the frequency of cardiovascular diseases, the digestive system, and metabolic disorders. The effect of GC on the course of RA, on comorbidity, and on the frequency of adverse outcomes has been discussed in this article. Presented results of our own studies demonstrate a high level of comorbidity in patients with advanced and late RA, relatively high frequency of long-term GC therapy. It was found that comorbid patients significantly less often achieve treatment goals and are more often on systemic GC therapy. The obtained results confirm the relationship between long-term therapy with systemic GC and comorbidity, as well as an insufficient response to rational therapy in patients with RA.