Burden of comorbidities and medication use in childbearing women with rheumatic diseases: a nationwide population-based study
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background/Aims: We aimed to estimate the prevalence of comorbidities and medication use in Korean women with rheumatic diseases (RDs) during their childbearing years. Methods: We included women aged 20 to 44 years with seropositive rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and ankylosing spondylitis (AS) (n = 41,547) and age-matched women without seropositive RA, SLE, and AS (n = 208,941) from the National Health Insurance Service-National Health Information Database (2009 to 2016). The prevalence of hypertension (HTN), hyperlipidemia (HLD), diabetes mellitus (DM), and cancer and the use of nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids (CSs), and disease-modifying anti-rheumatic drugs (DMARDs) were estimated. Results: Women of childbearing age with RDs were more likely to have at least one of the measured comorbidities than the controls (odds ratio [OR], 3.0; 95% confidence interval [CI], 2.9 to 3.1). The OR (95% CI) was 2.9 (2.8 to 3.0) for HTN, 2.8 (2.7 to 2.9) for HLD, 1.4 (1.4 to 1.5) for DM, and 1.3 (1.3 to 1.4) for cancer. The SLE group had the highest prevalence and odds of all four measured comorbidities. Almost all (97.9%) women of childbearing age with RDs were taking RD-related medications (NSAIDs, 81.6%; CSs, 77.8%; DMARDs, 87.3%). The RD group was 13.8 times more likely to take NSAIDs and 68.2 times more likely to take CSs than the controls. Use of NSAIDs was more prevalent in RA and AS than SLE, whereas use of CSs and DMARDs was more prevalent in RA and SLE than AS. Conclusions: Korean women with RDs have a greater burden of comorbidities and medication use during their childbearing years than women without RDs of the same age.
Abstract
Background/Aims: We aimed to estimate the prevalence of comorbidities and medication use in Korean women with rheumatic diseases (RDs) during their childbearing years. Methods: We included women aged 20 to 44 years with seropositive rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and ankylosing spondylitis (AS) (n = 41,547) and age-matched women without seropositive RA, SLE, and AS (n = 208,941) from the National Health Insurance Service-National Health Information Database (2009 to 2016). The prevalence of hypertension (HTN), hyperlipidemia (HLD), diabetes mellitus (DM), and cancer and the use of nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids (CSs), and disease-modifying anti-rheumatic drugs (DMARDs) were estimated. Results: Women of childbearing age with RDs were more likely to have at least one of the measured comorbidities than the controls (odds ratio [OR], 3.0; 95% confidence interval [CI], 2.9 to 3.1). The OR (95% CI) was 2.9 (2.8 to 3.0) for HTN, 2.8 (2.7 to 2.9) for HLD, 1.4 (1.4 to 1.5) for DM, and 1.3 (1.3 to 1.4) for cancer. The SLE group had the highest prevalence and odds of all four measured comorbidities. Almost all (97.9%) women of childbearing age with RDs were taking RD-related medications (NSAIDs, 81.6%; CSs, 77.8%; DMARDs, 87.3%). The RD group was 13.8 times more likely to take NSAIDs and 68.2 times more likely to take CSs than the controls. Use of NSAIDs was more prevalent in RA and AS than SLE, whereas use of CSs and DMARDs was more prevalent in RA and SLE than AS. Conclusions: Korean women with RDs have a greater burden of comorbidities and medication use during their childbearing years than women without RDs of the same age.
참고문헌 (43)
- Krause ML, "Management of rheumatoid arthritis during pregnancy : challenges and solutions", Open Access Rheumatol, 8, pp.23~36 (2016)
- Pons-Estel GJ, "Understanding the epidemiology and progression of systemic lupus erythematosus", Semin Arthritis Rheum, 39, pp.257~268 (2010)
- Timur H, "Pregnancy outcome in patients with ankylosing spondylitis", J Matern Fetal Neonatal Med, 29, pp.2470~2474 (2016)
- Bharti B, "Disease severity and pregnancy outcomes in women with rheumatoid arthritis : results from the organization of teratology information specialists autoimmune diseases in pregnancy project", J Rheumatol, 42, pp.1376~1382 (2015)
- Clowse ME, "The impact of increased lupus activity on obstetric outcomes", Arthritis Rheum, 52, pp.514~521 (2005)
- Smith CJ, "Birth outcomes and disease activity during pregnancy in a prospective cohort of women with psoriatic arthritis and ankylosing spondylitis", Arthritis Care Res(Hoboken), 72, pp.1029~1037 (2020)
- Akawatcharangura P, "Prevalence of premature ovarian failure in systemic lupus erythematosus patients treated with immunosuppressive agents in Thailand", Lupus, 25, pp.436~444 (2016)
- Gotestam Skorpen C, "The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation", Ann Rheum Dis, 75, pp.795~810 (2016)
- Mathieu S, "Cardiovascular events in ankylosing spondylitis : an updated meta-analysis", Semin Arthritis Rheum, 44, pp.551~555 (2015)
- Lindhardsen J, "The risk of myocardial infarction in rheumatoid arthritis and diabetes mellitus : a Danish nationwide cohort study", Ann Rheum Dis, 70, pp.929~934 (2011)
- Avina-Zubieta JA, "Risk of myocardial infarction and stroke in newly diagnosed systemic lupus erythematosus: a general population-based study", Arthritis Care Res(Hoboken), 69, pp.849~856 (2017)
- Roos-Hesselink J, "Pregnancy outcomes in women with cardiovascular disease : evolving trends over 10 years in the ESC Registry Of Pregnancy And Cardiac disease(ROPAC)", Eur Heart J, 40, pp.3848~3855 (2019)
- Abusief ME, "The effects of paclitaxel, dose density, and trastuzumab on treatment-related amenorrhea in premenopausal women with breast cancer", Cancer, 116, pp.791~798 (2010)
- Chung MK, "Incidence and prevalence of systemic lupus erythematosus among Korean women in childbearing years : a nationwide population-based study", Lupus, 30, pp.674~679 (2021)
- Hunter TM, "Prevalence of rheumatoid arthritis in the United States adult population in healthcare claims databases, 2004-2014", Rheumatol Int, 37, pp.1551~1557 (2017)
- Haroon NN, "Increasing proportion of female patients with ankylosing spondylitis : a population-based study of trends in the incidence and prevalence of AS", BMJ Open, 4, pp.e006634~ (2014)
- 송선옥, "Background and Data Configuration Process of a Nationwide Population-Based Study Using the Korean National Health Insurance System", Diabetes and Metabolism Journal, 38(5), pp.395~403 (2014), 대한당뇨병학회[DOI]
- Cheol Seong S, "Data resource profile : the National Health Information database of the National Health Insurance Service in South Korea", Int J Epidemiol, 46, pp.799~800 (2017)
- 황영재, "Validation of Administrative Big Database for Colorectal Cancer Searched by International Classification of Disease 10th Codes in Korean: A Retrospective Big-cohort Study", 대한암예방학회지, 23(4), pp.183~190 (2018), 대한암예방학회[DOI]
- Avina-Zubieta JA, "Risk of incident cardiovascular events in patients with rheumatoid arthritis : a meta-analysis of observational studies", Ann Rheum Dis, 71, pp.1524~1529 (2012)
- Hak AE, "Systemic lupus erythematosus and the risk of cardiovascular disease : results from the nurses’ health study", Arthritis Rheum, 61, pp.1396~1402 (2009)
- Manzi S, "Age-specific incidence rates of myocardial infarction and angina in women with systemic lupus erythematosus : comparison with the Framingham Study", Am J Epidemiol, 145, pp.408~415 (1997)
- Sabio JM, "Prevalence of and factors associated with hypertension in young and old women with systemic lupus erythematosus", J Rheumatol, 38, pp.1026~1032 (2011)
- Han C, "Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis", J Rheumatol, 33, pp.2167~2172 (2006)
- Urowitz MB, "Clinical manifestations and coronary artery disease risk factors at diagnosis of systemic lupus erythematosus : data from an international inception cohort", Lupus, 16, pp.731~735 (2007)
- Song L, "The risks of cancer development in systemic lupus erythematosus(SLE)patients : a systematic review and meta-analysis", Arthritis Res Ther, 20, pp.270~ (2018)
- Sun LM, "Increased risk of cancer for patients with ankylosing spondylitis : a nationwide population-based retrospective cohort study", Scand J Rheumatol, 43, pp.301~306 (2014)
- Simon TA, "Incidence of malignancy in adult patients with rheumatoid arthritis : a meta-analysis", Arthritis Res Ther, 17, pp.212~ (2015)
- Merz AA, "Sex differences in cardiovascular ageing", Heart, 102, pp.825~831 (2016)
- White MC, "Age and cancer risk : a potentially modifiable relationship", Am J Prev Med, 46(3 Suppl 1), pp.S7~S15 (2014)
- Fransen J, "Rheumatoid arthritis disadvantages younger patients for cardiovascular diseases : a meta-analysis", PLoS One, 11, pp.e0157360~ (2016)
- Rees F, "Burden of comorbidity in systemic lupus erythematosus in the UK, 1999-2012", Arthritis Care Res(Hoboken), 68, pp.819~827 (2016)
- Huang YP, "Increased risk of ischemic heart disease in young patients with newly diagnosed ankylosing spondylitis : a population-based longitudinal follow-up study", PLoS One, 8, pp.e64155~ (2013)
- Tallbacka KR, "Increased incidence of cancer in systemic lupus erythematosus : a Finnish cohort study with more than 25 years of follow-up", Scand J Rheumatol, 47, pp.461~464 (2018)
- Chang CC, "Ankylosing spondylitis and the risk of cancer", Oncol Lett, 14, pp.1315~1322 (2017)
- Coxib, "Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs : meta-analyses of individual participant data from randomised trials", Lancet, 382, pp.769~779 (2013)
- Morrison A, "Systematic review of trials of the effect of continued use of oral non-selective NSAIDs on blood pressure and hypertension", Curr Med Res Opin, 23, pp.2395~2404 (2007)
- Iaccarino L, "Premature coronary heart disease in SLE : can we prevent progression?", Lupus, 22, pp.1232~1242 (2013)
- Panoulas VF, "Long-term exposure to medium-dose glucocorticoid therapy associates with hypertension in patients with rheumatoid arthritis", Rheumatology(Oxford), 47, pp.72~75 (2008)
- Bernatsky S, "Lymphoma risk in systemic lupus : effects of disease activity versus treatment", Ann Rheum Dis, 73, pp.138~142 (2014)
- De Cock D, "Malignancy and rheumatoid arthritis : epidemiology, risk factors and management", Best Pract Res Clin Rheumatol, 32, pp.869~886 (2018)
- Ostensen M, "Sexual and reproductive health in rheumatic disease", Nat Rev Rheumatol, 13, pp.485~493 (2017)
- Micu MC, "Luteinized unruptured follicle syndrome increased by inactive disease and selective cyclooxygenase 2 inhibitors in women with inflammatory arthropathies", Arthritis Care Res(Hoboken), 63, pp.1334~1338 (2011)
