Clinical Rheumatology

, Volume 33, Issue 3, pp 315–321 | Cite as

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

  • Virginia Pascual-RamosEmail author
  • Irazú Contreras-Yáñez
  • Paula Rivera-Hoyos
  • Lorena Enríquez
  • Jaqueline Ramírez-Anguiano
Original Article


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.


Hearing loss Rheumatoid arthritis 





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Copyright information

© Clinical Rheumatology 2014

Authors and Affiliations

  • Virginia Pascual-Ramos
    • 1
    Email author
  • Irazú Contreras-Yáñez
    • 1
  • Paula Rivera-Hoyos
    • 2
  • Lorena Enríquez
    • 2
  • Jaqueline Ramírez-Anguiano
    • 2
  1. 1.Department of Immunology and RheumatologyInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMéxicoMexico
  2. 2.Department of OtorhinolaryngologyInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMéxicoMexico

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