When most people think about rheumatoid arthritis or autoimmune conditions, they picture swollen joints, stiff hands, and inflammation. But doctors and researchers are increasingly sounding the alarm: these diseases bring with them a whole set of “hidden” health risks—some of which can be more dangerous than the disease itself.
At the 2025 American College of Rheumatology (ACR) meeting, scientists shared new findings that shine a spotlight on these comorbidities—medical problems that develop alongside the primary disease. The message is clear: living with an autoimmune disease means keeping an eye on your whole body, not just your joints.
If you have an autoimmune or inflammatory disease, this study shows it’s important to regularly check for other health problems that often get missed — like heart disease, osteoporosis, infections, and cancer. Even if your main condition is well managed, you’re at higher risk for these issues, especially if you’re on immune-suppressing medications. Ask your doctor if you’re up to date on cancer screenings, heart health checks (like cholesterol and blood pressure), bone health (including vitamin D and calcium levels), vaccinations, and dental care. Many patients in the study had serious risks that hadn’t been caught, so bringing these up could help catch problems early and improve your long-term health.
If you have rheumatoid arthritis (RA), this study suggests that your estimated risk of developing heart failure might tell more about hidden heart damage than traditional cardiovascular risk scores alone. The researchers found that, in RA patients without known heart disease, a higher predicted heart failure risk was linked to worse coronary microvascular function (the small blood vessels in your heart) and, over time, more plaque buildup in the coronary arteries. In short: even if your standard risk scores for stroke or heart attack look low, your risk for heart failure could be signaling early changes in your heart’s vessels — meaning more advanced heart screening could be useful for people with RA.
For patients, this study shows that living with a rheumatic disease often comes with more than just joint pain or inflammation—about one-third to one-half of people also screen positive for anxiety, depression, or fibromyalgia symptoms. These conditions can make pain feel worse, add to fatigue, and even affect how active a disease appears on medical tests. The good news is that a simple questionnaire (the MDHAQ) can help doctors quickly spot these issues during routine visits, so they don’t get overlooked. Recognizing and addressing mental health and fibromyalgia symptoms alongside rheumatic disease can lead to more accurate treatment decisions and better overall care.
For patients with difficult-to-treat rheumatoid arthritis, this study shows that ongoing joint pain and disability are often caused not only by active inflammation but also by osteoarthritis, past joint damage, or other mechanical problems. This means that even when powerful RA medications reduce inflammation, symptoms may still persist because of these overlapping issues. Understanding this helps patients and doctors focus on a broader treatment plan—combining RA therapies with strategies like physical therapy, joint protection, pain management, or surgery—to better address the full range of problems affecting quality of life.
This study found that deaths linked to both rheumatoid arthritis and high blood pressure in the U.S. have risen sharply from 1999 to 2020, with especially high risks in women, older adults, Black and Hispanic patients, and those living in rural areas. For patients, this highlights that managing blood pressure is a vital part of RA care—controlling hypertension through regular monitoring, medication, and lifestyle changes can help lower cardiovascular risks and improve long-term survival
Even when patients with rheumatoid arthritis have only 0 or 1 swollen or tender joints (i.e. minimal objective signs), if their disease-activity scores (DAS28, CDAI, RAPID3) still rate them as “moderate/high,” nearly 86–96% of these patients report at least one non-inflammatory symptom or comorbidity (fatigue, back pain, neck pain, sleep problems, mood symptoms, fibromyalgia features, etc.) on the MDHAQ.
This study looked at people with rheumatic diseases (RA, SLE, OA) and found that social risk factors — like food insecurity, delaying care due to cost, and living in neighborhoods with disorder — are linked to a higher risk of major cardiovascular events (heart attack, stroke, coronary interventions), even after adjusting for age, sex, race, underlying disease, and comorbidities.
In people with rheumatoid arthritis (RA), pulmonary hypertension (PH) — high blood pressure in the arteries of the lungs — is more common when there is also interstitial lung disease (ILD), but it also happens in RA without ILD. The study found that RA patients with both ILD and PH tend to have worse lung function (lower forced vital capacity), more systemic inflammation, higher mortality, and develop disease at a younger age of death compared to those with RA plus ILD alone or RA alone. Certain groups — for example, Black patients and those with a history of smoking — were more likely to have lung disease and PH. For patients, this means extra vigilance is needed: symptoms like unexplained shortness of breath, cough, or decreased exercise tolerance should trigger evaluation for lung disease and PH, because detecting them earlier may allow better management and could improve outcomes.
Patients with rheumatic diseases (like RA, lupus, Sjögren’s) frequently suffer from oral problems — cavities, dry mouth, periodontal (gum) disease — both from the disease itself and from medications. A pilot program in Mexico implemented a collaborative clinic model where rheumatologists screen for oral health risk and refer patients to dentists trained in rheumatic-disease-related oral issues. Dentists then do exams (teeth, saliva tests), assess risk, and give personalized plans (hygiene advice, diet, fluoride use, etc.). Among 415 patients, oral issues were common: ~60% had dental caries; ~47% had decreased saliva flow; ~10% had missing teeth. Integrating dental care into the rheumatology setting increased detection of oral health problems, improved access to dental referrals, and made prevention & education more routine
This study highlights a significant underdiagnosis of hearing loss among patients with systemic autoimmune rheumatic diseases. While only 4.76% had previously been diagnosed, audiological assessments revealed that 46.9% actually had hearing loss, predominantly sensorineural, mild, and with a descending pattern. Conditions like systemic sclerosis (75%) and rheumatoid arthritis (60.6%) showed higher rates of hearing impairment. Given these findings, it’s crucial for healthcare providers to include routine auditory evaluations in the management of these patients to ensure early detection and appropriate intervention
This study found that in patients with rheumatoid arthritis (RA), the most common eye issue is dry eyes (xerophthalmia), affecting 94% of patients, with 78% reporting mild symptoms. Cataracts were present in 46% of patients, primarily of the nuclear type. Patients with moderate-to-severe dry eye symptoms had higher disease activity scores, indicating a potential link between eye problems and overall RA severity.
This study assessed the impact of a structured global review on managing comorbidities in patients with inflammatory arthritis (IA), including rheumatoid arthritis (RA) and spondyloarthritis (SpA). The review followed a standardized protocol aligned with EULAR recommendations, evaluating cardiovascular, bone, infection, and malignancy risks. The cohort included 63 patients (17 with RA and 46 with SpA) with a mean disease duration of 21.2 years. Results showed significant improvements in vaccination coverage (influenza from 40.7% to 66.1%, DTP from 57.4% to 73.0%) and skin cancer screening adherence (from 45.2% to 58.7%). Additionally, vitamin D deficiency rates decreased from 81.5% to 43.1%. However, cardiovascular risk management did not improve, possibly due to the absence of direct prescriptions. These findings suggest that structured global reviews can enhance certain aspects of comorbidity management in IA patients, but highlight the need for better coordination in managing complex comorbidities.
This scoping review examined cancer risks in patients with rheumatoid arthritis (RA), systemic sclerosis (SSc), and Sjögren’s syndrome (SS). The study identified specific cancer associations and risk factors for each condition. For instance, SSc was most commonly associated with liver or lung cancer, RA with lymphoma, and SS with hematologic malignancies, particularly non-Hodgkin’s lymphoma. Risk factors included positive anti-transcriptional intermediary factor 1 (TIF-1γ) in SSc, rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) positivity in RA, and low complement levels and lymphocytopenia in SS. Additionally, interstitial lung disease (ILD) was identified as a shared risk factor for malignancy in both RA and SSc. The authors emphasized the need for high-powered prospective studies to develop evidence-based, expert-driven screening guidelines to inform appropriate clinical care for these patients.
