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Cumulative disease activity predicts incidental hearing impairment in patients with rheumatoid arthritis (RA)

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Abstract

We previously reported that 24 % of 113 rheumatoid arthritis (RA) patients had hearing impairment (HI). We investigated if disease activity was a predictor of incidental HI. One hundred and four patients completed three consecutive 6 months-apart rheumatic evaluations and concomitant audiometric evaluations which included at least an interview, an otoscopic evaluation, and a pure tone audiometry. HI was defined if the average thresholds for at least one of low-, mid-, or high-frequency ranges were ≥25 decibels (dB) hearing level in one or both ears. Appropriated statistics was used. Internal review board approval was obtained. Patients were most frequently middle-aged (43.4 ± 13.3 years), female (89.4 %), and had median disease duration of 5 years and low disease activity. All were receiving RA treatment. At inclusion, 24 patients had HI which was sensorineural in 91.7% of them. Among the 80 patients without HI at baseline, 10 (12.5 %) developed incidental HI, and they had more disease activity either at baseline ([median, range] disease activity score-28 joints evaluated-C-reactive protein [DAS28-CRP], 3.9 [1.6–7.3] vs. 2.1 [1–8.7], p = 0.006) or cumulative previous incidental HI (3.4 [1.8–4.8] vs. 2 [1–6.2], p = 0.007) and were more frequently on combined methotrexate and sulfasalazine (20 vs. 1.4 %, p = 0.05) than their counterparts. In the adjusted Cox proportional model, cumulative DAS28-CRP was the only variable to predict incidental HI (odds ratio, 1.8; 95 % confidence interval, 1.1–2.7; p = 0.01). Almost 13 % of RA patients with short disease duration and low disease activity developed incidental HI during 1 year. Cumulative disease activity predicted incidental HI.

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Authors and Affiliations

  1. Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Colonia Sección XVI, Tlalpan, 14000, México, DF, Mexico

    Virginia Pascual-Ramos & Irazú Contreras-Yáñez

  2. Department of Otorhinolaryngology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Colonia Sección XVI, Tlalpan, 14000, México, DF, Mexico

    Paula Rivera-Hoyos, Lorena Enríquez & Jaqueline Ramírez-Anguiano

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  1. Virginia Pascual-Ramos
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  2. Irazú Contreras-Yáñez
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Correspondence to Virginia Pascual-Ramos.

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Pascual-Ramos, V., Contreras-Yáñez, I., Rivera-Hoyos, P. et al. Cumulative disease activity predicts incidental hearing impairment in patients with rheumatoid arthritis (RA). Clin Rheumatol 33, 315–321 (2014). https://doi.org/10.1007/s10067-014-2485-6

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  • DOI: https://doi.org/10.1007/s10067-014-2485-6

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