Comorbidities Impact Disease Activity in Spondyloarthritis Save

An analysis of a large population-based cohort of axial spondyloarthritis (axSpA) patients shows that comorbidities are common and are associated with higher disease activity and higher levels of functional impairment.

While the impact of comorbidity on rheumatoid arthritis and psoriatic arthritis is well known, their impact on axSpA disease outcomes are less well studied.

A random cohort of axSpA patients was chosen from health insurance data and the prevalence of comorbidities and pharmacological treatments were examined.

The study included 1776 axSpA patients, with a mean age of 56 years; and 46% were female.

A minority (17%) of the patients had no comorbid conditions; 41% had 1–2 comorbid conditions, 25% had 3–4 comorbid conditions and 17% had 5 or more comorbid conditions. The most prevalent comorbidities were hypertension (52%), depression (26%); chronic pulmonary disease (23%), asthma (10%) and diabetes (16%). 

The number of comorbidities was significantly associated with disease activity (BASDAI) and functional outcomes (BASFI).

While BASDAI scores were correlated with depression and COPD, the BASFI was associated with hypertension, depression, and chronic pulmonary disease.

Comorbidities in axSpA patients were associated with higher disease activity and higher levels of functional impairment. Higher disease activity and higher levels of functional impairment might be indicators of severe disease resulting in the development of comorbidities. Treatment strategies in axial spondyloarthritis should also address comorbidities.