Prevalence of comorbidities and evaluation of their screening in spondyloarthritis: Results of the international cross-sectional ASAS-COMOSPA study

Anna Moltó, Adrien Etcheto, Désirée van der Heijde, Robert Landewé, Filip van den Bosch, Wilson Bautista Molano, Ruben Burgos-Vargas, Peter P. Cheung, Eduardo Collantes-Estevez, Atulya (Atul) Deodhar, Bassel El-Zorkany, Shandor Erdes, Jieruo Gu, Najia Hajjaj-Hassouni, Uta Kiltz, Tae Hwan Kim, Mitsumasa Kishimoto, Shue Fen Luo, Pedro M. Machado, Walter P. MaksymowychJosé Maldonado-Cocco, Helena Marzo-Ortega, Carlo Maurizio Montecucco, Salih Ozgoçmen, Floris van Gaalen, Maxime Dougados

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67 Scopus citations

Abstract

Background Increased risk of some comorbidities has been reported in spondyloarthritis (SpA). Recommendations for detection/management of some of these comorbidities have been proposed, and it is known that a gap exists between these and their implementation in practice. Objective To evaluate (1) the prevalence of comorbidities and risk factors in different countries worldwide, (2) the gap between available recommendations and daily practice for management of these comorbidities and (3) the prevalence of previously unknown risk factors detected as a result of the present initiative. Methods Cross-sectional international study with 22 participating countries (from four continents), including 3984 patients with SpA according to the rheumatologist. Statistical analysis The prevalence of comorbidities (cardiovascular, infection, cancer, osteoporosis and gastrointestinal) and risk factors; percentage of patients optimally monitored for comorbidities according to available recommendations and percentage of patients for whom a risk factor was detected due to this study. Results The most frequent comorbidities were osteoporosis (13%) and gastroduodenal ulcer (11%). The most frequent risk factors were hypertension (34%), smoking (29%) and hypercholesterolaemia (27%). Substantial intercountry variability was observed for screening of comorbidities (eg, for LDL cholesterol measurement: from 8% (Taiwan) to 98% (Germany)). Systematic evaluation (eg, blood pressure (BP), cholesterol) during this study unveiled previously unknown risk factors (eg, elevated BP (14%)), emphasising the suboptimal monitoring of comorbidities. Conclusions A high prevalence of comorbidities in SpA has been shown. Rigorous application of systematic evaluation of comorbidities may permit earlier detection, which may ultimately result in an improved outcome of patients with SpA.

Original languageEnglish (US)
JournalAnnals of the Rheumatic Diseases
DOIs
StateAccepted/In press - Mar 15 2016

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ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Allergy

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Moltó, A., Etcheto, A., van der Heijde, D., Landewé, R., van den Bosch, F., Molano, W. B., Burgos-Vargas, R., Cheung, P. P., Collantes-Estevez, E., Deodhar, A. A., El-Zorkany, B., Erdes, S., Gu, J., Hajjaj-Hassouni, N., Kiltz, U., Kim, T. H., Kishimoto, M., Luo, S. F., Machado, P. M., ... Dougados, M. (Accepted/In press). Prevalence of comorbidities and evaluation of their screening in spondyloarthritis: Results of the international cross-sectional ASAS-COMOSPA study. Annals of the Rheumatic Diseases. https://doi.org/10.1136/annrheumdis-2015-208174