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The Association of Rheumatoid Arthritis and Its Treatment with Sinus Disease
KALEB MICHAUD and FREDERICK WOLFE ABSTRACT. Objective. To determine if rates of sinus disease are increased in patients with rheumatoid arthritis (RA) and whether RA treatment alters the risk of sinus disease. Methods. As part of a longitudinal study of rheumatic disease outcomes, 7,243 patients with RA, 1,667 with osteoarthritis (OA), and 447 with fibromyalgia (FM) were evaluated for important sinus problems in 2003. We defined an important sinus problem as one that required a physician visit. Results. The lifetime prevalence of sinus disorders among all patients was 42.9%. During the previous 6 months 22.3% of patients with RA, 23.9% with OA, and 25.1% with FM visited a physician for a sinus problem and 22.4%, 23.9%, and 25.1% , respectively, received a prescription medication for a sinus problem. After adjustment for age and sex, the rate of physician visits for a sinus problem was significantly lower for patients with RA (22.1%) compared to patients with OA (24.8%). The strongest predictor of sinus problems among all patients was a history of allergy or asthma. Sinus problems were more common among users of etanercept: odds ratio (OR) 1.2; 95% confidence interval (CI): 1.0-1.4 univariably, and OR 1.2; 95% CI: 1.0-1.4 multivariably. Sulfasalazine (OR 0.7; 95% CI: 0.5-0.9) and leflunomide (OR 0.8; 95% CI: 0.7-1.0) had a protective effect on sinus problems. Conclusions. Sinus problems are decreased in patients with RA compared to OA and FM. Slight protective effects on sinus problems are noted with sulfasalazine and leflunomide, and a slight increase in risk of sinus problems is noted with etanercept. (J Rheumatol 2006;33:2412-5) Key Indexing Terms:
SINUSITIS From the National Data Bank for Rheumatic Diseases, University of Kansas School of Medicine, Wichita, Kansas and the Center for Primary Care and Outcomes Research, Stanford University, Stanford, California, USA. K. Michaud, PhD, National Data Bank for Rheumatic Diseases and Center for Primary Care and Outcomes Research, Stanford University; F. Wolfe, MD, National Data Bank for Rheumatic Diseases, University of Kansas School of Medicine. Address reprint requests to Dr. F. Wolfe, National Data Bank for Rheumatic Diseases, Arthritis Research Center Foundation, 1035 N. Emporia, Suite 230, Wichita, KS, 67214, USA. E-mail: fwolfe@arthritis-research.org Accepted for publication July 18, 2006.
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