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Understanding comorbidities in RMD

By Priscilla Lynch - 18th Aug 2026

RMD
iStock.com/kazuma seki

The EULAR 2026 Congress showcased new data and ideas around various comorbidities and drug safety issues in people with rheumatic and musculoskeletal diseases (RMD), highlighting the need for integrated care.

A team in Colombia has been looking into the risk of cardiac arrhythmias and conduction disorders in adults with systemic autoimmune diseases compared with the general population – with the aim of identifying disease-specific patterns from a systematic review and meta-analysis. The work was presented in a poster at the 2026 Congress by Juan Sebastian Theran Leon and colleagues. Data from 40 studies were included, representing over 210,000 patients and more than 800,000 controls. Results showed the pooled risk of arrhythmia was significantly higher in those with an autoimmune disease versus controls. Systemic sclerosis and RA had the strongest associations, particularly with atrial fibrillation, ventricular arrhythmias, and atrioventricular block. Routine ECG and Holter monitoring should be considered as part of the standard evaluation of autoimmune patients to enable early detection and prevention of rhythm disturbances.

Like many RMD, juvenile idiopathic arthritis (JIA) is characterised by chronic inflammation, and associated with an increased risk of major comorbidities, including cardiovascular disease, chronic kidney disease, and type 2 diabetes. Imane Bardan explored this association using data from the Norwegian Patient Registry, finding a higher prevalence of ischemic heart disease, hypertension, and chronic kidney disease in adults with JIA, as well as other autoimmune conditions, such as type 1 diabetes, coeliac disease, autoimmune thyroiditis, and alopecia. Prospective all-cause mortality was higher in JIA than comparators, with a mortality rate of 2.4 versus 1.8 per 1,000 person-years. Neither comorbidities, autoimmune conditions, or all-cause mortality appeared to be affected by recent exposure to disease-modifying antirheumatic drugs. The work underscores the need for integrated care throughout adulthood.

Another poster at the Congress focused on cognitive impairment – a recognised comorbidity in immune-mediated inflammatory disorders. Alex Kaula and colleagues from Cambridge Cognition presented their findings on the feasibility, reliability, and sensitivity of a 90-second cognitive assessment delivered by smartphone to RMD patients, using data from the IDEA-FAST study. This examined healthy volunteers alongside participants with an RMD as well as two neurodegenerative diseases – seeing how they compared on a digit-symbol substitution task. People with an RMD had differences in cognitive performance (total number of items correct in 90 seconds) compared to healthy volunteers, ranging from –3.2 in inflammatory bowel disease to –6.7 in lupus. For reference, using the same age-adjusted model recorded differences of –11 in Parkinson’s and –10 in Huntington’s disease – providing a clear and clinically interpretable context for the observed effects. These kinds of low-burden assessments that can be delivered remotely could help address longstanding barriers to incorporating cognitive assessment into large-scale studies and disease monitoring in patients with RMD, said EULAR.

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Medical Independent 18th August 2026
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