Anna Moltó1, Adrien Etcheto1, Désirée van der Heijde2, Robert Landewé3, Filip van den Bosch4, Wilson Bautista Molano5, Ruben Burgos-Vargas6, Peter P Cheung7, Eduardo Collantes-Estevez8, Atul Deodhar9, Bassel El-Zorkany10, Shandor Erdes11, Jieruo Gu12, Najia Hajjaj-Hassouni13, Uta Kiltz14, Tae-Hwan Kim15, Mitsumasa Kishimoto16, Shue-Fen Luo17, Pedro M Machado18, Walter P Maksymowych19, José Maldonado-Cocco20, Helena Marzo-Ortega21, Carlo-Maurizio Montecucco22, Salih Ozgoçmen23, Floris van Gaalen2, Maxime Dougados1. 1. Rheumatology B Department, Paris Descartes University, Cochin Hospital, AP-HP, Paris, France INSERM (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France. 2. Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. 3. ARC, Amsterdam & Atrium MC Heerlen, Amsterdam, The Netherlands. 4. Department of Rheumatology, Ghent University Hospital, Ghent, Belgium. 5. Rheumatology Department, Faculty of Medicine, HMC/UMNG, Bogota, Colombia. 6. Servicio de Reumatologia, Hospital General de México and Universidad Nacional Autonoma de México, México City, Mexico. 7. Division of Rheumatology, National University Hospital, Singapore, Singapore. 8. Rheumatology Department, Reina Sofia Hospital; Maimonides Institute for Biomedical Research of Cordoba/University of Cordoba, Cordoba, Spain. 9. Div Arthritis/Rheumatic Diseases (OPO9), Oregon Health and Science University, Portland, USA. 10. Department of Rheumatology, Cairo University, Cairo, Egypt. 11. Russian Academy of Sciences, Moscow, Russia. 12. Division of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guanzhou, China. 13. Department of Rheumatology, Mohamed Vth University, URAC 30, El Ayachi Hospital, Salé, Morocco Faculty of Medicine and Pharmacy, Rabat, Morocco. 14. Rheumazentrum Ruhrgebiet, Herne, Germany. 15. Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea. 16. Immuno-Rheumatology Center, St Luke's International Hospital, St Luke's International University, Tokyo, Japan. 17. Department of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan. 18. Department of Rheumatology, University of Coimbra, Coimbra, Portugal University College London, London, UK. 19. Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. 20. Rheumatology Section, Instituto de Rehabilitacion Psicofisica and Argentine Rheumatologic Foundation "Dr Osvaldo Carcia Morteo", Buenos Aires, Argentina. 21. NIHR-Leeds Musculoskeletal Biomedical research Unit, Leeds Institute of Molecular Medicina, University of Leeds, Leeds, UK. 22. Univerity of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy. 23. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Erciyes University, Gevher Nesibe Hospital, Kayseri, Turkey.
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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Authors: Sizheng Steven Zhao; Helga Radner; Stefan Siebert; Stephen J Duffield; Daniel Thong; David M Hughes; Robert J Moots; Daniel H Solomon; Nicola J Goodson Journal: Rheumatology (Oxford) Date: 2019-10-01 Impact factor: 7.580
Authors: Gustavo Citera; Wilson Bautista-Molano; Ingris Peláez-Ballestas; Valderilio F Azevedo; Risto A Perich; José A Méndez-Rodríguez; Mariel S Cutri; Cecilia E Borlenghi Journal: Adv Rheumatol Date: 2021-01-08
Authors: U Kiltz; J Braun; A Becker; J-F Chenot; M Dreimann; L Hammel; A Heiligenhaus; K-G Hermann; R Klett; D Krause; K-F Kreitner; U Lange; A Lauterbach; W Mau; R Mössner; U Oberschelp; S Philipp; U Pleyer; M Rudwaleit; E Schneider; T L Schulte; J Sieper; A Stallmach; B Swoboda; M Winking Journal: Z Rheumatol Date: 2019-12 Impact factor: 1.372