MULTIMORBIDITY AND CHRONIC DISEASE BURDEN IN AUTOIMMUNE DISORDERS
Abstract
Autoimmune diseases are chronic immune-mediated disorders that are frequently accompanied by multiple chronic comorbid conditions. Accumulating evidence indicates that patients with autoimmune diseases have a substantially increased risk of developing cardiovascular, metabolic, musculoskeletal, renal, and psychiatric disorders, which significantly worsen clinical outcomes and quality of life. The aim of this study was to evaluate the prevalence and clinical significance of chronic comorbidities in autoimmune diseases and to explore underlying pathogenic mechanisms. A narrative review of the literature published between 2010 and 2024 was conducted using PubMed, Scopus, and Google Scholar databases. The reviewed studies demonstrate that persistent systemic inflammation, immune dysregulation, shared genetic susceptibility, and long-term immunosuppressive therapy play a central role in the development of multimorbidity. The coexistence of multiple chronic conditions complicates disease management and is associated with increased morbidity, mortality, and healthcare utilization. Early identification of comorbidities and implementation of multidisciplinary, patient-centered management strategies are essential to improve long-term outcomes in patients with autoimmune diseases.
Keywords
autoimmune disorders, multimorbidity, chronic diseases, immune-mediated inflammation
References
- Somers EC, Thomas SL, Smeeth L, Hall AJ. Incidence of autoimmune diseases and associated chronic conditions. Ann Rheum Dis. 2015;74(4):666–673.
- Aviña-Zubieta JA, Abrahamowicz M, De Vera MA, et al. Cardiovascular disease risk in autoimmune disorders. Arthritis Rheum. 2012;64(1):1–11.
- Dregan A, Charlton J, Chowienczyk P, Gulliford MC. Chronic inflammatory disorders and multimorbidity. BMJ Open. 2014;4:e005867.
- Marrie RA, Reider N, Cohen J, et al. A systematic review of comorbidity in autoimmune disease. Autoimmun Rev. 2015;14(2):164–175.
- Dougados M, Soubrier M, Antunez A, et al. Prevalence of comorbidities in autoimmune and inflammatory diseases. Ann Rheum Dis. 2014;73(1):62–68.
- Bruce IN. Cardiovascular and metabolic comorbidities in autoimmune disease. Rheumatology. 2016;55(2):ii1–ii6.
- Mok CC. Multimorbidity and organ damage in systemic lupus erythematosus. Nat Rev Rheumatol. 2017;13(6):345–355.
- Hanly JG, Urowitz MB, Su L, et al. Depression and anxiety in autoimmune diseases. Arthritis Care Res. 2014;66(2):406–412.
- Smolen JS, Aletaha D, McInnes IB. Immune-mediated inflammation and chronic disease burden. Lancet. 2016;388(10055):2023–2038.
- van den Hoek J, Roorda LD, Boshuizen HC, et al. Mortality and multimorbidity in autoimmune diseases. Arthritis Care Res. 2017;69(8):1204–1212.