RA Misc: Confoundings & Comorbidities

Pain Thresholds Tied to RA Disease Activity

Pain sensitization associated with disease activity composites

Composite clinical disease activity scores over-estimate disease activity in patients with low pain thresholds or with central sensitization of pain.  Imaging with ultrasound may help to refine assessment.

Weight Loss in RA Linked to CV, Cancer Mortality

Systemic inflammation may underlie mortality risk in men

While weight loss may help conditions of overload like knee osteoarthritis, and fat reduction may reduce inflammation and acute phase reactants, persistent weight loss (especially muscle and bone mass) in RA may signify significant chronic inflammatory burden, translating to heightened cardiovascular and malignancy risks.  This is referred to as the “Obesity Paradox” in RA.

Opportunistic Infections Low in RA

Image result for infection

There has been a significant decline in incidence since 2002