MULTIMORBIDITY, the presence of multiple co-existing health conditions, has emerged as a critical factor influencing survival and physical function in patients with systemic sclerosis (SSc), according to a large cohort study of 2,000 participants. This research underscores the importance for healthcare professionals managing systemic sclerosis to not only focus on the disease itself but also recognize and treat accompanying conditions like hypertension, ischemic heart disease, and renal disease.
The study, conducted within the Australian Scleroderma Cohort, revealed that 20% of individuals with systemic sclerosis experience multimorbidity, defined by a Charlson Comorbidity Index score of 4 or higher. Notably, these patients faced a significantly higher risk of mortality, with multimorbidity linked to a 57% increase in the hazard of death (hazard ratio [HR] 1.57, 95% confidence interval [CI] 1.30–1.91; P < 0.01). Renal disease stood out as the comorbidity with the most pronounced impact on survival (HR 2.41, 95% CI 1.46–3.98). For physicians treating patients with systemic sclerosis, these findings highlight the need for comprehensive care strategies that extend beyond the primary disease. Key comorbidities in this cohort included hypertension (81%), dyslipidemia (67%), obstructive lung disease (50%), malignancy (49%), and ischemic heart disease (40%). These conditions not only affect survival but also significantly impair physical function. The study demonstrated that multimorbidity was associated with poorer physical function (regression coefficient +0.17 units, 95% CI 0.13–0.21; P < 0.01), with peripheral vascular disease, left ventricular dysfunction, ischemic heart disease, and obstructive lung disease exerting the greatest effects. For clinicians, the takeaway is clear: a more integrated approach that addresses both systemic sclerosis and its comorbidities could improve patient outcomes. By recognizing the broader health profile of patients, especially those with multiple coexisting conditions, rheumatologists and other healthcare providers can potentially extend survival and enhance quality of life. This study adds to the growing evidence that systemic sclerosis care must evolve to encompass the management of comorbid conditions, urging a shift toward more personalized and holistic treatment plans. Reference: Fairly JL et al. The Prognostic and Functional Impact of Multimorbidity in Systemic Sclerosis. ACR Open Rheumatol. 2025;7(4):e70034.
