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Peña M, Quirós-Donate J, Pérez Fernández E, Crespí-Villarías N, Dieguez Costa E, García-Vadillo A, Espinosa M, Macía-Villa C, Morell-Hita JL, Martinez-Prada C, Villaverde V, Morado Quiroga I, Guzón-Illescas O, Barbadillo C, Fernandez Prada M, Godoy H, Herranz Varela A, Galindo Izquierdo M, Mazzucchelli R. Orthopedic Surgery in Rheumatoid Arthritis: Results from the Spanish National Registry of Hospitalized Patients over 17 Years. J Rheumatol 2019; 47:341-348. [PMID: 31203231 DOI: 10.3899/jrheum.190182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To analyze the trend of orthopedic surgery (OS) rates on patients with rheumatoid arthritis (RA). METHODS Retrospective observational study based on information provided by the Spanish National System of Hospital Data Surveillance. All hospitalizations of patients with RA for orthopedic surgery [total hip arthroplasty (THA), total knee arthroplasty (TKA), arthrodesis, and upper limb arthroplasty (ULA)] during 1999-2015 were analyzed. The age-adjusted rate was calculated. Generalized linear models were used for trend analysis. RESULTS There were 21,088 OS in patients over 20 years of age (77.9% women). OS rate adjusted by age was 754.63/100,000 RA patients/year (women 707.4, men 861.1). Neither an increasing nor a decreasing trend was noted for the total OS. However, trend and age interacted, so in the age ranges 20-40 years and 40-60 years, an annual reduction of 2.69% and 2.97%, respectively, was noted. In the age ranges over 80 years and 60-80 years, we noted an annual increase of 5.40% and 1.09%, respectively. The average age at time of OS increased 5.5 years during the period analyzed. For specific surgeries, a global annual reduction was noted in rates for arthrodesis. In THA, there was an annual reduction in patients under 80 years. In TKA and ULA, there was an annual reduction in patients under 60 years. CONCLUSION Although the overall OS rate has not changed, there is a decrease in the rate of arthrodesis at all ages, THA in patients under 80 years of age, as well as TKA and ULA in patients under 60 years of age.
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Affiliation(s)
- Marina Peña
- From the Department of Rehabilitation, and Department of Rheumatology, Hospital Universitario Fundación Alcorcón, and Department of Clinical Research, Hospital Universitario Fundación Alcorcón; Centro de Salud La Rivota (Alcorcón); Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; Department of Rheumatology, Hospital Universitario de la Princesa; Department of Rheumatology, Hospital Universitario Puerta de Hierro; Department of Rheumatology, Hospital Universitario Severo Ochoa; Department of Rheumatology, Hospital Universitario Ramón y Cajal; Department of Rheumatology, Hospital Universitario Clínico San Carlos; Department of Rheumatology, Hospital Universitario de Móstoles; Department of Rheumatology, Hospital Universitario del Henares; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid; Department of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain.,M. Peña, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; J. Quirós-Donate, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón; E. Pérez Fernández, MD, Department of Clinical Research, Hospital Universitario Fundación Alcorcón; N. Crespí-Villarías, MD, Centro de Salud La Rivota (Alcorcón); E. Dieguez Costa, MD, Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; A. García-Vadillo, MD, PhD, Department of Rheumatology, Hospital Universitario de la Princesa; M. Espinosa, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; C. Macía-Villa, MD, Department of Rheumatology, Hospital Universitario Severo Ochoa; J.L. Morell-Hita, MD, Department of Rheumatology, Hospital Universitario Ramón y Cajal; C. Martinez-Prada, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; V. Villaverde, MD, Department of Rheumatology, Hospital Universitario de Móstoles; I. Morado Quiroga, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; O. Guzón-Illescas, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; C. Barbadillo, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; M. Fernandez Prada, MD, Department of Rheumatology, Hospital Universitario de Guadalajara; H. Godoy, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; A. Herranz Varela, MD, Department of Rheumatology, Hospital Universitario del Henares; M. Galindo Izquierdo, MD, PhD, Department of Rheumatology, Hospital Universitario 12 de Octubre; R. Mazzucchelli, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón
| | - Javier Quirós-Donate
- From the Department of Rehabilitation, and Department of Rheumatology, Hospital Universitario Fundación Alcorcón, and Department of Clinical Research, Hospital Universitario Fundación Alcorcón; Centro de Salud La Rivota (Alcorcón); Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; Department of Rheumatology, Hospital Universitario de la Princesa; Department of Rheumatology, Hospital Universitario Puerta de Hierro; Department of Rheumatology, Hospital Universitario Severo Ochoa; Department of Rheumatology, Hospital Universitario Ramón y Cajal; Department of Rheumatology, Hospital Universitario Clínico San Carlos; Department of Rheumatology, Hospital Universitario de Móstoles; Department of Rheumatology, Hospital Universitario del Henares; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid; Department of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain.,M. Peña, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; J. Quirós-Donate, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón; E. Pérez Fernández, MD, Department of Clinical Research, Hospital Universitario Fundación Alcorcón; N. Crespí-Villarías, MD, Centro de Salud La Rivota (Alcorcón); E. Dieguez Costa, MD, Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; A. García-Vadillo, MD, PhD, Department of Rheumatology, Hospital Universitario de la Princesa; M. Espinosa, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; C. Macía-Villa, MD, Department of Rheumatology, Hospital Universitario Severo Ochoa; J.L. Morell-Hita, MD, Department of Rheumatology, Hospital Universitario Ramón y Cajal; C. Martinez-Prada, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; V. Villaverde, MD, Department of Rheumatology, Hospital Universitario de Móstoles; I. Morado Quiroga, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; O. Guzón-Illescas, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; C. Barbadillo, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; M. Fernandez Prada, MD, Department of Rheumatology, Hospital Universitario de Guadalajara; H. Godoy, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; A. Herranz Varela, MD, Department of Rheumatology, Hospital Universitario del Henares; M. Galindo Izquierdo, MD, PhD, Department of Rheumatology, Hospital Universitario 12 de Octubre; R. Mazzucchelli, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón
| | - Elia Pérez Fernández
- From the Department of Rehabilitation, and Department of Rheumatology, Hospital Universitario Fundación Alcorcón, and Department of Clinical Research, Hospital Universitario Fundación Alcorcón; Centro de Salud La Rivota (Alcorcón); Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; Department of Rheumatology, Hospital Universitario de la Princesa; Department of Rheumatology, Hospital Universitario Puerta de Hierro; Department of Rheumatology, Hospital Universitario Severo Ochoa; Department of Rheumatology, Hospital Universitario Ramón y Cajal; Department of Rheumatology, Hospital Universitario Clínico San Carlos; Department of Rheumatology, Hospital Universitario de Móstoles; Department of Rheumatology, Hospital Universitario del Henares; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid; Department of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain.,M. Peña, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; J. Quirós-Donate, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón; E. Pérez Fernández, MD, Department of Clinical Research, Hospital Universitario Fundación Alcorcón; N. Crespí-Villarías, MD, Centro de Salud La Rivota (Alcorcón); E. Dieguez Costa, MD, Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; A. García-Vadillo, MD, PhD, Department of Rheumatology, Hospital Universitario de la Princesa; M. Espinosa, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; C. Macía-Villa, MD, Department of Rheumatology, Hospital Universitario Severo Ochoa; J.L. Morell-Hita, MD, Department of Rheumatology, Hospital Universitario Ramón y Cajal; C. Martinez-Prada, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; V. Villaverde, MD, Department of Rheumatology, Hospital Universitario de Móstoles; I. Morado Quiroga, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; O. Guzón-Illescas, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; C. Barbadillo, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; M. Fernandez Prada, MD, Department of Rheumatology, Hospital Universitario de Guadalajara; H. Godoy, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; A. Herranz Varela, MD, Department of Rheumatology, Hospital Universitario del Henares; M. Galindo Izquierdo, MD, PhD, Department of Rheumatology, Hospital Universitario 12 de Octubre; R. Mazzucchelli, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón
| | - Natalia Crespí-Villarías
- From the Department of Rehabilitation, and Department of Rheumatology, Hospital Universitario Fundación Alcorcón, and Department of Clinical Research, Hospital Universitario Fundación Alcorcón; Centro de Salud La Rivota (Alcorcón); Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; Department of Rheumatology, Hospital Universitario de la Princesa; Department of Rheumatology, Hospital Universitario Puerta de Hierro; Department of Rheumatology, Hospital Universitario Severo Ochoa; Department of Rheumatology, Hospital Universitario Ramón y Cajal; Department of Rheumatology, Hospital Universitario Clínico San Carlos; Department of Rheumatology, Hospital Universitario de Móstoles; Department of Rheumatology, Hospital Universitario del Henares; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid; Department of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain.,M. Peña, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; J. Quirós-Donate, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón; E. Pérez Fernández, MD, Department of Clinical Research, Hospital Universitario Fundación Alcorcón; N. Crespí-Villarías, MD, Centro de Salud La Rivota (Alcorcón); E. Dieguez Costa, MD, Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; A. García-Vadillo, MD, PhD, Department of Rheumatology, Hospital Universitario de la Princesa; M. Espinosa, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; C. Macía-Villa, MD, Department of Rheumatology, Hospital Universitario Severo Ochoa; J.L. Morell-Hita, MD, Department of Rheumatology, Hospital Universitario Ramón y Cajal; C. Martinez-Prada, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; V. Villaverde, MD, Department of Rheumatology, Hospital Universitario de Móstoles; I. Morado Quiroga, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; O. Guzón-Illescas, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; C. Barbadillo, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; M. Fernandez Prada, MD, Department of Rheumatology, Hospital Universitario de Guadalajara; H. Godoy, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; A. Herranz Varela, MD, Department of Rheumatology, Hospital Universitario del Henares; M. Galindo Izquierdo, MD, PhD, Department of Rheumatology, Hospital Universitario 12 de Octubre; R. Mazzucchelli, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón
| | - Elisa Dieguez Costa
- From the Department of Rehabilitation, and Department of Rheumatology, Hospital Universitario Fundación Alcorcón, and Department of Clinical Research, Hospital Universitario Fundación Alcorcón; Centro de Salud La Rivota (Alcorcón); Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; Department of Rheumatology, Hospital Universitario de la Princesa; Department of Rheumatology, Hospital Universitario Puerta de Hierro; Department of Rheumatology, Hospital Universitario Severo Ochoa; Department of Rheumatology, Hospital Universitario Ramón y Cajal; Department of Rheumatology, Hospital Universitario Clínico San Carlos; Department of Rheumatology, Hospital Universitario de Móstoles; Department of Rheumatology, Hospital Universitario del Henares; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid; Department of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain.,M. Peña, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; J. Quirós-Donate, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón; E. Pérez Fernández, MD, Department of Clinical Research, Hospital Universitario Fundación Alcorcón; N. Crespí-Villarías, MD, Centro de Salud La Rivota (Alcorcón); E. Dieguez Costa, MD, Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; A. García-Vadillo, MD, PhD, Department of Rheumatology, Hospital Universitario de la Princesa; M. Espinosa, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; C. Macía-Villa, MD, Department of Rheumatology, Hospital Universitario Severo Ochoa; J.L. Morell-Hita, MD, Department of Rheumatology, Hospital Universitario Ramón y Cajal; C. Martinez-Prada, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; V. Villaverde, MD, Department of Rheumatology, Hospital Universitario de Móstoles; I. Morado Quiroga, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; O. Guzón-Illescas, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; C. Barbadillo, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; M. Fernandez Prada, MD, Department of Rheumatology, Hospital Universitario de Guadalajara; H. Godoy, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; A. Herranz Varela, MD, Department of Rheumatology, Hospital Universitario del Henares; M. Galindo Izquierdo, MD, PhD, Department of Rheumatology, Hospital Universitario 12 de Octubre; R. Mazzucchelli, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón
| | - Alberto García-Vadillo
- From the Department of Rehabilitation, and Department of Rheumatology, Hospital Universitario Fundación Alcorcón, and Department of Clinical Research, Hospital Universitario Fundación Alcorcón; Centro de Salud La Rivota (Alcorcón); Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; Department of Rheumatology, Hospital Universitario de la Princesa; Department of Rheumatology, Hospital Universitario Puerta de Hierro; Department of Rheumatology, Hospital Universitario Severo Ochoa; Department of Rheumatology, Hospital Universitario Ramón y Cajal; Department of Rheumatology, Hospital Universitario Clínico San Carlos; Department of Rheumatology, Hospital Universitario de Móstoles; Department of Rheumatology, Hospital Universitario del Henares; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid; Department of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain.,M. Peña, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; J. Quirós-Donate, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón; E. Pérez Fernández, MD, Department of Clinical Research, Hospital Universitario Fundación Alcorcón; N. Crespí-Villarías, MD, Centro de Salud La Rivota (Alcorcón); E. Dieguez Costa, MD, Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; A. García-Vadillo, MD, PhD, Department of Rheumatology, Hospital Universitario de la Princesa; M. Espinosa, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; C. Macía-Villa, MD, Department of Rheumatology, Hospital Universitario Severo Ochoa; J.L. Morell-Hita, MD, Department of Rheumatology, Hospital Universitario Ramón y Cajal; C. Martinez-Prada, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; V. Villaverde, MD, Department of Rheumatology, Hospital Universitario de Móstoles; I. Morado Quiroga, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; O. Guzón-Illescas, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; C. Barbadillo, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; M. Fernandez Prada, MD, Department of Rheumatology, Hospital Universitario de Guadalajara; H. Godoy, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; A. Herranz Varela, MD, Department of Rheumatology, Hospital Universitario del Henares; M. Galindo Izquierdo, MD, PhD, Department of Rheumatology, Hospital Universitario 12 de Octubre; R. Mazzucchelli, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón
| | - María Espinosa
- From the Department of Rehabilitation, and Department of Rheumatology, Hospital Universitario Fundación Alcorcón, and Department of Clinical Research, Hospital Universitario Fundación Alcorcón; Centro de Salud La Rivota (Alcorcón); Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; Department of Rheumatology, Hospital Universitario de la Princesa; Department of Rheumatology, Hospital Universitario Puerta de Hierro; Department of Rheumatology, Hospital Universitario Severo Ochoa; Department of Rheumatology, Hospital Universitario Ramón y Cajal; Department of Rheumatology, Hospital Universitario Clínico San Carlos; Department of Rheumatology, Hospital Universitario de Móstoles; Department of Rheumatology, Hospital Universitario del Henares; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid; Department of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain.,M. Peña, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; J. Quirós-Donate, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón; E. Pérez Fernández, MD, Department of Clinical Research, Hospital Universitario Fundación Alcorcón; N. Crespí-Villarías, MD, Centro de Salud La Rivota (Alcorcón); E. Dieguez Costa, MD, Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; A. García-Vadillo, MD, PhD, Department of Rheumatology, Hospital Universitario de la Princesa; M. Espinosa, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; C. Macía-Villa, MD, Department of Rheumatology, Hospital Universitario Severo Ochoa; J.L. Morell-Hita, MD, Department of Rheumatology, Hospital Universitario Ramón y Cajal; C. Martinez-Prada, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; V. Villaverde, MD, Department of Rheumatology, Hospital Universitario de Móstoles; I. Morado Quiroga, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; O. Guzón-Illescas, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; C. Barbadillo, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; M. Fernandez Prada, MD, Department of Rheumatology, Hospital Universitario de Guadalajara; H. Godoy, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; A. Herranz Varela, MD, Department of Rheumatology, Hospital Universitario del Henares; M. Galindo Izquierdo, MD, PhD, Department of Rheumatology, Hospital Universitario 12 de Octubre; R. Mazzucchelli, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón
| | - Cristina Macía-Villa
- From the Department of Rehabilitation, and Department of Rheumatology, Hospital Universitario Fundación Alcorcón, and Department of Clinical Research, Hospital Universitario Fundación Alcorcón; Centro de Salud La Rivota (Alcorcón); Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; Department of Rheumatology, Hospital Universitario de la Princesa; Department of Rheumatology, Hospital Universitario Puerta de Hierro; Department of Rheumatology, Hospital Universitario Severo Ochoa; Department of Rheumatology, Hospital Universitario Ramón y Cajal; Department of Rheumatology, Hospital Universitario Clínico San Carlos; Department of Rheumatology, Hospital Universitario de Móstoles; Department of Rheumatology, Hospital Universitario del Henares; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid; Department of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain.,M. Peña, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; J. Quirós-Donate, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón; E. Pérez Fernández, MD, Department of Clinical Research, Hospital Universitario Fundación Alcorcón; N. Crespí-Villarías, MD, Centro de Salud La Rivota (Alcorcón); E. Dieguez Costa, MD, Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; A. García-Vadillo, MD, PhD, Department of Rheumatology, Hospital Universitario de la Princesa; M. Espinosa, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; C. Macía-Villa, MD, Department of Rheumatology, Hospital Universitario Severo Ochoa; J.L. Morell-Hita, MD, Department of Rheumatology, Hospital Universitario Ramón y Cajal; C. Martinez-Prada, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; V. Villaverde, MD, Department of Rheumatology, Hospital Universitario de Móstoles; I. Morado Quiroga, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; O. Guzón-Illescas, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; C. Barbadillo, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; M. Fernandez Prada, MD, Department of Rheumatology, Hospital Universitario de Guadalajara; H. Godoy, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; A. Herranz Varela, MD, Department of Rheumatology, Hospital Universitario del Henares; M. Galindo Izquierdo, MD, PhD, Department of Rheumatology, Hospital Universitario 12 de Octubre; R. Mazzucchelli, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón
| | - Jose Luis Morell-Hita
- From the Department of Rehabilitation, and Department of Rheumatology, Hospital Universitario Fundación Alcorcón, and Department of Clinical Research, Hospital Universitario Fundación Alcorcón; Centro de Salud La Rivota (Alcorcón); Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; Department of Rheumatology, Hospital Universitario de la Princesa; Department of Rheumatology, Hospital Universitario Puerta de Hierro; Department of Rheumatology, Hospital Universitario Severo Ochoa; Department of Rheumatology, Hospital Universitario Ramón y Cajal; Department of Rheumatology, Hospital Universitario Clínico San Carlos; Department of Rheumatology, Hospital Universitario de Móstoles; Department of Rheumatology, Hospital Universitario del Henares; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid; Department of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain.,M. Peña, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; J. Quirós-Donate, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón; E. Pérez Fernández, MD, Department of Clinical Research, Hospital Universitario Fundación Alcorcón; N. Crespí-Villarías, MD, Centro de Salud La Rivota (Alcorcón); E. Dieguez Costa, MD, Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; A. García-Vadillo, MD, PhD, Department of Rheumatology, Hospital Universitario de la Princesa; M. Espinosa, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; C. Macía-Villa, MD, Department of Rheumatology, Hospital Universitario Severo Ochoa; J.L. Morell-Hita, MD, Department of Rheumatology, Hospital Universitario Ramón y Cajal; C. Martinez-Prada, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; V. Villaverde, MD, Department of Rheumatology, Hospital Universitario de Móstoles; I. Morado Quiroga, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; O. Guzón-Illescas, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; C. Barbadillo, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; M. Fernandez Prada, MD, Department of Rheumatology, Hospital Universitario de Guadalajara; H. Godoy, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; A. Herranz Varela, MD, Department of Rheumatology, Hospital Universitario del Henares; M. Galindo Izquierdo, MD, PhD, Department of Rheumatology, Hospital Universitario 12 de Octubre; R. Mazzucchelli, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón
| | - Cristina Martinez-Prada
- From the Department of Rehabilitation, and Department of Rheumatology, Hospital Universitario Fundación Alcorcón, and Department of Clinical Research, Hospital Universitario Fundación Alcorcón; Centro de Salud La Rivota (Alcorcón); Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; Department of Rheumatology, Hospital Universitario de la Princesa; Department of Rheumatology, Hospital Universitario Puerta de Hierro; Department of Rheumatology, Hospital Universitario Severo Ochoa; Department of Rheumatology, Hospital Universitario Ramón y Cajal; Department of Rheumatology, Hospital Universitario Clínico San Carlos; Department of Rheumatology, Hospital Universitario de Móstoles; Department of Rheumatology, Hospital Universitario del Henares; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid; Department of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain.,M. Peña, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; J. Quirós-Donate, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón; E. Pérez Fernández, MD, Department of Clinical Research, Hospital Universitario Fundación Alcorcón; N. Crespí-Villarías, MD, Centro de Salud La Rivota (Alcorcón); E. Dieguez Costa, MD, Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; A. García-Vadillo, MD, PhD, Department of Rheumatology, Hospital Universitario de la Princesa; M. Espinosa, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; C. Macía-Villa, MD, Department of Rheumatology, Hospital Universitario Severo Ochoa; J.L. Morell-Hita, MD, Department of Rheumatology, Hospital Universitario Ramón y Cajal; C. Martinez-Prada, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; V. Villaverde, MD, Department of Rheumatology, Hospital Universitario de Móstoles; I. Morado Quiroga, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; O. Guzón-Illescas, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; C. Barbadillo, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; M. Fernandez Prada, MD, Department of Rheumatology, Hospital Universitario de Guadalajara; H. Godoy, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; A. Herranz Varela, MD, Department of Rheumatology, Hospital Universitario del Henares; M. Galindo Izquierdo, MD, PhD, Department of Rheumatology, Hospital Universitario 12 de Octubre; R. Mazzucchelli, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón
| | - Virginia Villaverde
- From the Department of Rehabilitation, and Department of Rheumatology, Hospital Universitario Fundación Alcorcón, and Department of Clinical Research, Hospital Universitario Fundación Alcorcón; Centro de Salud La Rivota (Alcorcón); Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; Department of Rheumatology, Hospital Universitario de la Princesa; Department of Rheumatology, Hospital Universitario Puerta de Hierro; Department of Rheumatology, Hospital Universitario Severo Ochoa; Department of Rheumatology, Hospital Universitario Ramón y Cajal; Department of Rheumatology, Hospital Universitario Clínico San Carlos; Department of Rheumatology, Hospital Universitario de Móstoles; Department of Rheumatology, Hospital Universitario del Henares; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid; Department of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain.,M. Peña, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; J. Quirós-Donate, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón; E. Pérez Fernández, MD, Department of Clinical Research, Hospital Universitario Fundación Alcorcón; N. Crespí-Villarías, MD, Centro de Salud La Rivota (Alcorcón); E. Dieguez Costa, MD, Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; A. García-Vadillo, MD, PhD, Department of Rheumatology, Hospital Universitario de la Princesa; M. Espinosa, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; C. Macía-Villa, MD, Department of Rheumatology, Hospital Universitario Severo Ochoa; J.L. Morell-Hita, MD, Department of Rheumatology, Hospital Universitario Ramón y Cajal; C. Martinez-Prada, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; V. Villaverde, MD, Department of Rheumatology, Hospital Universitario de Móstoles; I. Morado Quiroga, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; O. Guzón-Illescas, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; C. Barbadillo, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; M. Fernandez Prada, MD, Department of Rheumatology, Hospital Universitario de Guadalajara; H. Godoy, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; A. Herranz Varela, MD, Department of Rheumatology, Hospital Universitario del Henares; M. Galindo Izquierdo, MD, PhD, Department of Rheumatology, Hospital Universitario 12 de Octubre; R. Mazzucchelli, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón
| | - Inmaculada Morado Quiroga
- From the Department of Rehabilitation, and Department of Rheumatology, Hospital Universitario Fundación Alcorcón, and Department of Clinical Research, Hospital Universitario Fundación Alcorcón; Centro de Salud La Rivota (Alcorcón); Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; Department of Rheumatology, Hospital Universitario de la Princesa; Department of Rheumatology, Hospital Universitario Puerta de Hierro; Department of Rheumatology, Hospital Universitario Severo Ochoa; Department of Rheumatology, Hospital Universitario Ramón y Cajal; Department of Rheumatology, Hospital Universitario Clínico San Carlos; Department of Rheumatology, Hospital Universitario de Móstoles; Department of Rheumatology, Hospital Universitario del Henares; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid; Department of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain.,M. Peña, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; J. Quirós-Donate, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón; E. Pérez Fernández, MD, Department of Clinical Research, Hospital Universitario Fundación Alcorcón; N. Crespí-Villarías, MD, Centro de Salud La Rivota (Alcorcón); E. Dieguez Costa, MD, Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; A. García-Vadillo, MD, PhD, Department of Rheumatology, Hospital Universitario de la Princesa; M. Espinosa, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; C. Macía-Villa, MD, Department of Rheumatology, Hospital Universitario Severo Ochoa; J.L. Morell-Hita, MD, Department of Rheumatology, Hospital Universitario Ramón y Cajal; C. Martinez-Prada, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; V. Villaverde, MD, Department of Rheumatology, Hospital Universitario de Móstoles; I. Morado Quiroga, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; O. Guzón-Illescas, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; C. Barbadillo, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; M. Fernandez Prada, MD, Department of Rheumatology, Hospital Universitario de Guadalajara; H. Godoy, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; A. Herranz Varela, MD, Department of Rheumatology, Hospital Universitario del Henares; M. Galindo Izquierdo, MD, PhD, Department of Rheumatology, Hospital Universitario 12 de Octubre; R. Mazzucchelli, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón
| | - Olalla Guzón-Illescas
- From the Department of Rehabilitation, and Department of Rheumatology, Hospital Universitario Fundación Alcorcón, and Department of Clinical Research, Hospital Universitario Fundación Alcorcón; Centro de Salud La Rivota (Alcorcón); Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; Department of Rheumatology, Hospital Universitario de la Princesa; Department of Rheumatology, Hospital Universitario Puerta de Hierro; Department of Rheumatology, Hospital Universitario Severo Ochoa; Department of Rheumatology, Hospital Universitario Ramón y Cajal; Department of Rheumatology, Hospital Universitario Clínico San Carlos; Department of Rheumatology, Hospital Universitario de Móstoles; Department of Rheumatology, Hospital Universitario del Henares; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid; Department of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain.,M. Peña, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; J. Quirós-Donate, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón; E. Pérez Fernández, MD, Department of Clinical Research, Hospital Universitario Fundación Alcorcón; N. Crespí-Villarías, MD, Centro de Salud La Rivota (Alcorcón); E. Dieguez Costa, MD, Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; A. García-Vadillo, MD, PhD, Department of Rheumatology, Hospital Universitario de la Princesa; M. Espinosa, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; C. Macía-Villa, MD, Department of Rheumatology, Hospital Universitario Severo Ochoa; J.L. Morell-Hita, MD, Department of Rheumatology, Hospital Universitario Ramón y Cajal; C. Martinez-Prada, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; V. Villaverde, MD, Department of Rheumatology, Hospital Universitario de Móstoles; I. Morado Quiroga, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; O. Guzón-Illescas, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; C. Barbadillo, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; M. Fernandez Prada, MD, Department of Rheumatology, Hospital Universitario de Guadalajara; H. Godoy, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; A. Herranz Varela, MD, Department of Rheumatology, Hospital Universitario del Henares; M. Galindo Izquierdo, MD, PhD, Department of Rheumatology, Hospital Universitario 12 de Octubre; R. Mazzucchelli, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón
| | - Carmen Barbadillo
- From the Department of Rehabilitation, and Department of Rheumatology, Hospital Universitario Fundación Alcorcón, and Department of Clinical Research, Hospital Universitario Fundación Alcorcón; Centro de Salud La Rivota (Alcorcón); Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; Department of Rheumatology, Hospital Universitario de la Princesa; Department of Rheumatology, Hospital Universitario Puerta de Hierro; Department of Rheumatology, Hospital Universitario Severo Ochoa; Department of Rheumatology, Hospital Universitario Ramón y Cajal; Department of Rheumatology, Hospital Universitario Clínico San Carlos; Department of Rheumatology, Hospital Universitario de Móstoles; Department of Rheumatology, Hospital Universitario del Henares; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid; Department of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain.,M. Peña, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; J. Quirós-Donate, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón; E. Pérez Fernández, MD, Department of Clinical Research, Hospital Universitario Fundación Alcorcón; N. Crespí-Villarías, MD, Centro de Salud La Rivota (Alcorcón); E. Dieguez Costa, MD, Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; A. García-Vadillo, MD, PhD, Department of Rheumatology, Hospital Universitario de la Princesa; M. Espinosa, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; C. Macía-Villa, MD, Department of Rheumatology, Hospital Universitario Severo Ochoa; J.L. Morell-Hita, MD, Department of Rheumatology, Hospital Universitario Ramón y Cajal; C. Martinez-Prada, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; V. Villaverde, MD, Department of Rheumatology, Hospital Universitario de Móstoles; I. Morado Quiroga, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; O. Guzón-Illescas, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; C. Barbadillo, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; M. Fernandez Prada, MD, Department of Rheumatology, Hospital Universitario de Guadalajara; H. Godoy, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; A. Herranz Varela, MD, Department of Rheumatology, Hospital Universitario del Henares; M. Galindo Izquierdo, MD, PhD, Department of Rheumatology, Hospital Universitario 12 de Octubre; R. Mazzucchelli, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón
| | - Manuel Fernandez Prada
- From the Department of Rehabilitation, and Department of Rheumatology, Hospital Universitario Fundación Alcorcón, and Department of Clinical Research, Hospital Universitario Fundación Alcorcón; Centro de Salud La Rivota (Alcorcón); Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; Department of Rheumatology, Hospital Universitario de la Princesa; Department of Rheumatology, Hospital Universitario Puerta de Hierro; Department of Rheumatology, Hospital Universitario Severo Ochoa; Department of Rheumatology, Hospital Universitario Ramón y Cajal; Department of Rheumatology, Hospital Universitario Clínico San Carlos; Department of Rheumatology, Hospital Universitario de Móstoles; Department of Rheumatology, Hospital Universitario del Henares; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid; Department of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain.,M. Peña, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; J. Quirós-Donate, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón; E. Pérez Fernández, MD, Department of Clinical Research, Hospital Universitario Fundación Alcorcón; N. Crespí-Villarías, MD, Centro de Salud La Rivota (Alcorcón); E. Dieguez Costa, MD, Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; A. García-Vadillo, MD, PhD, Department of Rheumatology, Hospital Universitario de la Princesa; M. Espinosa, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; C. Macía-Villa, MD, Department of Rheumatology, Hospital Universitario Severo Ochoa; J.L. Morell-Hita, MD, Department of Rheumatology, Hospital Universitario Ramón y Cajal; C. Martinez-Prada, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; V. Villaverde, MD, Department of Rheumatology, Hospital Universitario de Móstoles; I. Morado Quiroga, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; O. Guzón-Illescas, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; C. Barbadillo, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; M. Fernandez Prada, MD, Department of Rheumatology, Hospital Universitario de Guadalajara; H. Godoy, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; A. Herranz Varela, MD, Department of Rheumatology, Hospital Universitario del Henares; M. Galindo Izquierdo, MD, PhD, Department of Rheumatology, Hospital Universitario 12 de Octubre; R. Mazzucchelli, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón
| | - Hilda Godoy
- From the Department of Rehabilitation, and Department of Rheumatology, Hospital Universitario Fundación Alcorcón, and Department of Clinical Research, Hospital Universitario Fundación Alcorcón; Centro de Salud La Rivota (Alcorcón); Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; Department of Rheumatology, Hospital Universitario de la Princesa; Department of Rheumatology, Hospital Universitario Puerta de Hierro; Department of Rheumatology, Hospital Universitario Severo Ochoa; Department of Rheumatology, Hospital Universitario Ramón y Cajal; Department of Rheumatology, Hospital Universitario Clínico San Carlos; Department of Rheumatology, Hospital Universitario de Móstoles; Department of Rheumatology, Hospital Universitario del Henares; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid; Department of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain.,M. Peña, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; J. Quirós-Donate, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón; E. Pérez Fernández, MD, Department of Clinical Research, Hospital Universitario Fundación Alcorcón; N. Crespí-Villarías, MD, Centro de Salud La Rivota (Alcorcón); E. Dieguez Costa, MD, Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; A. García-Vadillo, MD, PhD, Department of Rheumatology, Hospital Universitario de la Princesa; M. Espinosa, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; C. Macía-Villa, MD, Department of Rheumatology, Hospital Universitario Severo Ochoa; J.L. Morell-Hita, MD, Department of Rheumatology, Hospital Universitario Ramón y Cajal; C. Martinez-Prada, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; V. Villaverde, MD, Department of Rheumatology, Hospital Universitario de Móstoles; I. Morado Quiroga, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; O. Guzón-Illescas, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; C. Barbadillo, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; M. Fernandez Prada, MD, Department of Rheumatology, Hospital Universitario de Guadalajara; H. Godoy, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; A. Herranz Varela, MD, Department of Rheumatology, Hospital Universitario del Henares; M. Galindo Izquierdo, MD, PhD, Department of Rheumatology, Hospital Universitario 12 de Octubre; R. Mazzucchelli, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón
| | - Angela Herranz Varela
- From the Department of Rehabilitation, and Department of Rheumatology, Hospital Universitario Fundación Alcorcón, and Department of Clinical Research, Hospital Universitario Fundación Alcorcón; Centro de Salud La Rivota (Alcorcón); Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; Department of Rheumatology, Hospital Universitario de la Princesa; Department of Rheumatology, Hospital Universitario Puerta de Hierro; Department of Rheumatology, Hospital Universitario Severo Ochoa; Department of Rheumatology, Hospital Universitario Ramón y Cajal; Department of Rheumatology, Hospital Universitario Clínico San Carlos; Department of Rheumatology, Hospital Universitario de Móstoles; Department of Rheumatology, Hospital Universitario del Henares; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid; Department of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain.,M. Peña, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; J. Quirós-Donate, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón; E. Pérez Fernández, MD, Department of Clinical Research, Hospital Universitario Fundación Alcorcón; N. Crespí-Villarías, MD, Centro de Salud La Rivota (Alcorcón); E. Dieguez Costa, MD, Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; A. García-Vadillo, MD, PhD, Department of Rheumatology, Hospital Universitario de la Princesa; M. Espinosa, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; C. Macía-Villa, MD, Department of Rheumatology, Hospital Universitario Severo Ochoa; J.L. Morell-Hita, MD, Department of Rheumatology, Hospital Universitario Ramón y Cajal; C. Martinez-Prada, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; V. Villaverde, MD, Department of Rheumatology, Hospital Universitario de Móstoles; I. Morado Quiroga, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; O. Guzón-Illescas, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; C. Barbadillo, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; M. Fernandez Prada, MD, Department of Rheumatology, Hospital Universitario de Guadalajara; H. Godoy, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; A. Herranz Varela, MD, Department of Rheumatology, Hospital Universitario del Henares; M. Galindo Izquierdo, MD, PhD, Department of Rheumatology, Hospital Universitario 12 de Octubre; R. Mazzucchelli, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón
| | - María Galindo Izquierdo
- From the Department of Rehabilitation, and Department of Rheumatology, Hospital Universitario Fundación Alcorcón, and Department of Clinical Research, Hospital Universitario Fundación Alcorcón; Centro de Salud La Rivota (Alcorcón); Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; Department of Rheumatology, Hospital Universitario de la Princesa; Department of Rheumatology, Hospital Universitario Puerta de Hierro; Department of Rheumatology, Hospital Universitario Severo Ochoa; Department of Rheumatology, Hospital Universitario Ramón y Cajal; Department of Rheumatology, Hospital Universitario Clínico San Carlos; Department of Rheumatology, Hospital Universitario de Móstoles; Department of Rheumatology, Hospital Universitario del Henares; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid; Department of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain.,M. Peña, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; J. Quirós-Donate, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón; E. Pérez Fernández, MD, Department of Clinical Research, Hospital Universitario Fundación Alcorcón; N. Crespí-Villarías, MD, Centro de Salud La Rivota (Alcorcón); E. Dieguez Costa, MD, Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; A. García-Vadillo, MD, PhD, Department of Rheumatology, Hospital Universitario de la Princesa; M. Espinosa, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; C. Macía-Villa, MD, Department of Rheumatology, Hospital Universitario Severo Ochoa; J.L. Morell-Hita, MD, Department of Rheumatology, Hospital Universitario Ramón y Cajal; C. Martinez-Prada, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; V. Villaverde, MD, Department of Rheumatology, Hospital Universitario de Móstoles; I. Morado Quiroga, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; O. Guzón-Illescas, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; C. Barbadillo, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; M. Fernandez Prada, MD, Department of Rheumatology, Hospital Universitario de Guadalajara; H. Godoy, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; A. Herranz Varela, MD, Department of Rheumatology, Hospital Universitario del Henares; M. Galindo Izquierdo, MD, PhD, Department of Rheumatology, Hospital Universitario 12 de Octubre; R. Mazzucchelli, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón
| | - Ramón Mazzucchelli
- From the Department of Rehabilitation, and Department of Rheumatology, Hospital Universitario Fundación Alcorcón, and Department of Clinical Research, Hospital Universitario Fundación Alcorcón; Centro de Salud La Rivota (Alcorcón); Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; Department of Rheumatology, Hospital Universitario de la Princesa; Department of Rheumatology, Hospital Universitario Puerta de Hierro; Department of Rheumatology, Hospital Universitario Severo Ochoa; Department of Rheumatology, Hospital Universitario Ramón y Cajal; Department of Rheumatology, Hospital Universitario Clínico San Carlos; Department of Rheumatology, Hospital Universitario de Móstoles; Department of Rheumatology, Hospital Universitario del Henares; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid; Department of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain. .,M. Peña, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; J. Quirós-Donate, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón; E. Pérez Fernández, MD, Department of Clinical Research, Hospital Universitario Fundación Alcorcón; N. Crespí-Villarías, MD, Centro de Salud La Rivota (Alcorcón); E. Dieguez Costa, MD, Department of Diagnostic Imaging, Hospital Vithas Nuestra Señora de América; A. García-Vadillo, MD, PhD, Department of Rheumatology, Hospital Universitario de la Princesa; M. Espinosa, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; C. Macía-Villa, MD, Department of Rheumatology, Hospital Universitario Severo Ochoa; J.L. Morell-Hita, MD, Department of Rheumatology, Hospital Universitario Ramón y Cajal; C. Martinez-Prada, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; V. Villaverde, MD, Department of Rheumatology, Hospital Universitario de Móstoles; I. Morado Quiroga, MD, Department of Rheumatology, Hospital Universitario Clínico San Carlos; O. Guzón-Illescas, MD, Department of Rehabilitation, Hospital Universitario Fundación Alcorcón; C. Barbadillo, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; M. Fernandez Prada, MD, Department of Rheumatology, Hospital Universitario de Guadalajara; H. Godoy, MD, Department of Rheumatology, Hospital Universitario Puerta de Hierro; A. Herranz Varela, MD, Department of Rheumatology, Hospital Universitario del Henares; M. Galindo Izquierdo, MD, PhD, Department of Rheumatology, Hospital Universitario 12 de Octubre; R. Mazzucchelli, MD, PhD, Department of Rheumatology, Hospital Universitario Fundación Alcorcón.
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Myasoedova E, Gabriel SE, Matteson EL, Davis JM, Therneau TM, Crowson CS. Decreased Cardiovascular Mortality in Patients with Incident Rheumatoid Arthritis (RA) in Recent Years: Dawn of a New Era in Cardiovascular Disease in RA? J Rheumatol 2017; 44:732-739. [PMID: 28365576 PMCID: PMC5457313 DOI: 10.3899/jrheum.161154] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2017] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To assess trends in cardiovascular (CV) mortality in patients with incident rheumatoid arthritis (RA) in 2000-07 versus the previous decades, compared with non-RA subjects. METHODS The study population consisted of Olmsted County, Minnesota, USA residents with incident RA (age ≥ 18 yrs, 1987 American College of Rheumatology criteria was met in 1980-2007) and non-RA subjects from the same underlying population with similar age, sex, and calendar year of index. All subjects were followed until death, migration, or December 31, 2014. Followup was truncated for comparability. Aalen-Johansen methods were used to estimate CV mortality rates, adjusting for competing risk of other causes. Cox proportional hazards models were used to compare CV mortality by decade. RESULTS The study included 813 patients with RA and 813 non-RA subjects (mean age 55.9 yrs; 68% women for both groups). Patients with incident RA in 2000-07 had markedly lower 10-year overall CV mortality (2.7%, 95% CI 0.6-4.9%) and coronary heart disease (CHD) mortality (1.1%, 95% CI 0.0-2.7%) than patients diagnosed in 1990-99 (7.1%, 95% CI 3.9-10.1% and 4.5%, 95% CI 1.9-7.1%, respectively; HR for overall CV death: 0.43, 95% CI 0.19-0.94; CHD death: HR 0.21, 95% CI 0.05-0.95). This improvement in CV mortality persisted after accounting for CV risk factors. Ten-year overall CV mortality and CHD mortality in 2000-07 RA incidence cohort was similar to non-RA subjects (p = 0.95 and p = 0.79, respectively). CONCLUSION Our findings suggest significantly improved overall CV mortality, particularly CHD mortality, in patients with RA in recent years. Further studies are needed to examine the reasons for this improvement.
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Affiliation(s)
- Elena Myasoedova
- From the Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science; Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, Rochester, Minnesota; Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
- E. Myasoedova, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science; C.S. Crowson, MS, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science, and Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; E.L. Matteson, MD MPH, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science, and Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; J.M. Davis III, MD, MS, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science; T.M. Therneau, PhD, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; S.E. Gabriel, MD, MSc, Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, and Rutgers Robert Wood Johnson Medical School.
| | - Sherine E Gabriel
- From the Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science; Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, Rochester, Minnesota; Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
- E. Myasoedova, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science; C.S. Crowson, MS, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science, and Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; E.L. Matteson, MD MPH, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science, and Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; J.M. Davis III, MD, MS, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science; T.M. Therneau, PhD, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; S.E. Gabriel, MD, MSc, Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, and Rutgers Robert Wood Johnson Medical School
| | - Eric L Matteson
- From the Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science; Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, Rochester, Minnesota; Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
- E. Myasoedova, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science; C.S. Crowson, MS, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science, and Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; E.L. Matteson, MD MPH, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science, and Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; J.M. Davis III, MD, MS, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science; T.M. Therneau, PhD, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; S.E. Gabriel, MD, MSc, Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, and Rutgers Robert Wood Johnson Medical School
| | - John M Davis
- From the Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science; Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, Rochester, Minnesota; Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
- E. Myasoedova, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science; C.S. Crowson, MS, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science, and Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; E.L. Matteson, MD MPH, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science, and Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; J.M. Davis III, MD, MS, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science; T.M. Therneau, PhD, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; S.E. Gabriel, MD, MSc, Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, and Rutgers Robert Wood Johnson Medical School
| | - Terry M Therneau
- From the Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science; Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, Rochester, Minnesota; Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
- E. Myasoedova, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science; C.S. Crowson, MS, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science, and Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; E.L. Matteson, MD MPH, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science, and Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; J.M. Davis III, MD, MS, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science; T.M. Therneau, PhD, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; S.E. Gabriel, MD, MSc, Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, and Rutgers Robert Wood Johnson Medical School
| | - Cynthia S Crowson
- From the Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science; Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, Rochester, Minnesota; Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
- E. Myasoedova, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science; C.S. Crowson, MS, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science, and Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; E.L. Matteson, MD MPH, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science, and Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; J.M. Davis III, MD, MS, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science; T.M. Therneau, PhD, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; S.E. Gabriel, MD, MSc, Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, and Rutgers Robert Wood Johnson Medical School
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