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



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.



Cross-sectional international study with 22 participating countries (from four continents), including 3984 patients with SpA according to the rheumatologist.



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.



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.



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.
Rheumatology B Department, Paris Descartes University, Cochin Hospital, AP-HP, Paris, France INSERM (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France.
Anna
A
Moltó
Rheumatology B Department, Paris Descartes University, Cochin Hospital, AP-HP, Paris, France INSERM (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France.
Adrien
A
Etcheto
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
Désirée
0000-0002-5781-158X
D
van der Heijde
ARC, Amsterdam & Atrium MC Heerlen, Amsterdam, The Netherlands.
Robert
R
Landewé
Department of Rheumatology, Ghent University Hospital, Ghent, Belgium.
Filip
F
van den Bosch
Rheumatology Department, Faculty of Medicine, HMC/UMNG, Bogota, Colombia.
Wilson
W
Bautista Molano
Servicio de Reumatologia, Hospital General de México and Universidad Nacional Autonoma de México, México City, Mexico.
Ruben
R
Burgos-Vargas
Division of Rheumatology, National University Hospital, Singapore, Singapore.
Peter P
PP
Cheung
Rheumatology Department, Reina Sofia Hospital; Maimonides Institute for Biomedical Research of Cordoba/University of Cordoba, Cordoba, Spain.
Eduardo
E
Collantes-Estevez
Div Arthritis/Rheumatic Diseases (OPO9), Oregon Health and Science University, Portland, USA.
Atul
A
Deodhar
Department of Rheumatology, Cairo University, Cairo, Egypt.
Bassel
B
El-Zorkany
Russian Academy of Sciences, Moscow, Russia.
Shandor
S
Erdes
Division of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guanzhou, China.
Jieruo
J
Gu
Department of Rheumatology, Mohamed Vth University, URAC 30, El Ayachi Hospital, Salé, Morocco Faculty of Medicine and Pharmacy, Rabat, Morocco.
Najia
N
Hajjaj-Hassouni
Rheumazentrum Ruhrgebiet, Herne, Germany.
Uta
U
Kiltz
Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea.
Tae-Hwan
TH
Kim
Immuno-Rheumatology Center, St Luke's International Hospital, St Luke's International University, Tokyo, Japan.
Mitsumasa
M
Kishimoto
Department of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan.
Shue-Fen
SF
Luo
Department of Rheumatology, University of Coimbra, Coimbra, Portugal University College London, London, UK.
Pedro M
PM
Machado
Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Walter P
WP
Maksymowych
Rheumatology Section, Instituto de Rehabilitacion Psicofisica and Argentine Rheumatologic Foundation "Dr Osvaldo Carcia Morteo", Buenos Aires, Argentina.
José
J
Maldonado-Cocco
NIHR-Leeds Musculoskeletal Biomedical research Unit, Leeds Institute of Molecular Medicina, University of Leeds, Leeds, UK.
Helena
H
Marzo-Ortega
Univerity of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
Carlo-Maurizio
CM
Montecucco
Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Erciyes University, Gevher Nesibe Hospital, Kayseri, Turkey.
Salih
S
Ozgoçmen
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
Floris
F
van Gaalen
Rheumatology B Department, Paris Descartes University, Cochin Hospital, AP-HP, Paris, France INSERM (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France.
Maxime
M
Dougados
D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D003141:Communicable Diseases / Q000453:epidemiology* / Q000209:etiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology; D010024:Osteoporosis / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012307:Risk Factors; D025241:Spondylarthritis / Q000453:epidemiology* / Q000209:etiology
Cardiovascular Disease; Epidemiology; Infections; Osteoporosis; Spondyloarthritis