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  • Patterns of comorbidities differentially affect long-term functional evolution and disease activity in patients with ‘difficult to treat’ rheumatoid arthritis

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Rheumatoid arthritis
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Patterns of comorbidities differentially affect long-term functional evolution and disease activity in patients with ‘difficult to treat’ rheumatoid arthritis
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  • Published on: 1 March 2024
    “In D2T RA patients, rotator cuff tendinopathy increased disease activity”
    • David Vega-Morales, Rheumatologist Instituto Mexicano del Seguro Social. IMSS Hospital General de Zona Número 17.
    • Other Contributors:
      • Jorge Medina-Castillo, Dr.
      • Rodrigo J. Castillo-de la Garza, Dr.
      • Jorge A. Esquivel-Valerio, Dr.
      • Lorenia De la Cruz-Becerra, Dra.
      • Dionicio A. Galarza-Delgado, Rheumatologist
      • Alondra E. Montoya-Montes, medical intern of social service

    We have read with particular interest the article published in your journal, "Patterns of comorbidities differentially affect long-term functional evolution and disease activity in patients with 'difficult to treat' rheumatoid arthritis," where it was demonstrated that the lack of improvement in disease activity and the presence of comorbidities could be predictive factors of difficult-to-treat rheumatoid arthritis (RA). It is noteworthy the effect size that pathologies classified as osteoarthritis have (OR 1.68), even at the same level as the DAS28 ESR at the beginning of biological treatment, whereas soft tissue pathologies were not categorized. (1)
    Rheumatic regional pain syndromes usually affect the shoulder, causing pain and functional impairment. Rotator cuff tendinopathy (RCT) affects the supraspinatus, infraspinatus, subscapularis, and teres minor muscles less frequently and is the most common cause of shoulder pain, present in up to 85% of cases. (2)
    Underdiagnosed shoulder tendinopathy in patients with RA may be associated with elevated clinimetric scores, leading to incorrect treatment of both conditions.
    We conducted a cross-sectional, observational, comparative study from March to April 2022 in patients from the Rheumatology Service at a reference hospital in northern Mexico. The presence or absence of RCT was evaluated through the following tests: painful arc, "drop arm test" for the supraspinatus, internal rota...

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    Conflict of Interest:
    None declared.