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. 2016 Jun;75(6):1016-23.
doi: 10.1136/annrheumdis-2015-208174. Epub 2015 Oct 21.

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

Anna Moltó  1 , Adrien Etcheto  1 , Désirée van der Heijde  2 , Robert Landewé  3 , Filip van den Bosch  4 , Wilson Bautista Molano  5 , Ruben Burgos-Vargas  6 , Peter P Cheung  7 , Eduardo Collantes-Estevez  8 , Atul Deodhar  9 , Bassel El-Zorkany  10 , Shandor Erdes  11 , Jieruo Gu  12 , Najia Hajjaj-Hassouni  13 , Uta Kiltz  14 , Tae-Hwan Kim  15 , Mitsumasa Kishimoto  16 , Shue-Fen Luo  17 , Pedro M Machado  18 , Walter P Maksymowych  19 , José Maldonado-Cocco  20 , Helena Marzo-Ortega  21 , Carlo-Maurizio Montecucco  22 , Salih Ozgoçmen  23 , Floris van Gaalen  2 , Maxime Dougados  1
Affiliations

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

Anna Moltó et al. Ann Rheum Dis. 2016 Jun.

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.

Keywords: Cardiovascular Disease; Epidemiology; Infections; Osteoporosis; Spondyloarthritis.

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