Journal Article

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

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

2016

Overview

BackgroundIncreased 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.ObjectiveTo 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.MethodsCross-sectional international study with 22 participating countries (from four continents), including 3984 patients with SpA according to the rheumatologist.Statistical analysisThe 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.ResultsThe 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.ConclusionsA 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.

• Publisher: Elsevier Limited
• Subject: Adult / Amyloidosis / Cancer therapies / Cardiovascular Diseases - epidemiology / Cardiovascular Diseases - etiology / Case reports / Clinical medicine / Colon / Communicable Diseases - epidemiology / Communicable Diseases - etiology / Comorbidity / Cross-Sectional Studies / Data analysis / Diabetes / Disease / Family medical history / Female / Fractures / Gastrointestinal Diseases - epidemiology / Gastrointestinal Diseases - etiology / Heart attacks / Hepatitis / Humans / Hypertension / Infections / Inflammatory bowel disease / Male / Mass Screening - methods / Mass Screening - statistics & numerical data / Middle Aged / Mortality / Neoplasms - epidemiology / Neoplasms - etiology / Osteoporosis / Osteoporosis - epidemiology / Osteoporosis - etiology / Patients / Prevalence / Prostate / Psoriatic arthritis / Risk Factors / Skin cancer / Spondylarthritis - epidemiology / Spondylarthritis - etiology / Steroids