{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:42:25Z","timestamp":1787013745386,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T00:00:00Z","timestamp":1651536000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Comorbidities contribute both to morbidity and mortality in rheumatoid arthritis (RA). The aim of the current study was to investigate the prevalence and spectrum of comorbidities in South Africans with established RA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective, consecutive case record review of 500 Black South African patients with established disease of \u22655\u00a0years attending a tertiary rheumatology service was performed. Common comorbidities including those listed in the Charlson Comorbidity Score (CCS) were documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Most patients, 463 known alive (AG) and 37 known deceased (DG), were female (87%). Mean (SD) age and disease duration were 60 (11.1) and 10.7 (5.0) years respectively, and 98% had \u22651 comorbidities. Median CCS was 2, significantly higher in DG than AG (4 vs 2,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a0.0001). Despite hypertension (70%) and hypercholesterolemia (47%) being the commonest comorbidities overall and type 2 diabetes (T2D) occurring in 15.4%, clinical cardiovascular events were rare (0.6%). Peptic ulcer disease (odds ratio [OR]\u00a0=\u00a08.67), congestive cardiac failure (OR\u00a0=\u00a07.09), serious infections (OR\u00a0=\u00a07.02) and tuberculosis (OR\u00a0=\u00a02.56) were significantly more common in DG than AG. Multivariate analysis showed that American College of Rheumatology functional class 3\/4 was associated with increased risk for serious infections (OR\u00a0=\u00a03.84) and tuberculosis (OR\u00a0=\u00a02.10).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite the high burden of cardiometabolic comorbidities in South Africans with established RA, cardiovascular events were rare. Serious infections and tuberculosis, both associated with severe functional disability, are a major cause of morbidity and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1756-185x.14328","type":"journal-article","created":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T01:19:02Z","timestamp":1651627142000},"page":"699-704","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Comorbidities in Black South Africans with established rheumatoid arthritis"],"prefix":"10.1111","volume":"25","author":[{"given":"Vikash","family":"Lala","sequence":"first","affiliation":[{"name":"Department of Internal Medicine University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Tikly","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Chris Hani Baragwanath Academic Hospital University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eustasius","family":"Musenge","sequence":"additional","affiliation":[{"name":"School of Public Health University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2900-1042","authenticated-orcid":false,"given":"Nimmisha","family":"Govind","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Chris Hani Baragwanath Academic Hospital University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,3]]},"reference":[{"issue":"43","key":"e_1_2_8_2_1","first-page":"1227","article-title":"Rheumatoid arthritis in the Bantu","volume":"44","author":"Anderson IF","year":"1970","journal-title":"S Afr Med J"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-017-3907-y"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/03009742.2012.676065"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kes262"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.118430"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21950"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar2669"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102013\u2010204223"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/rap\/rky005"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(99)00124-9"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310302"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780350502"},{"key":"e_1_2_8_15_1","first-page":"1","article-title":"Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. 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