Comorbidities in Spondyloarthritis
- 145 Downloads
Spondyloarthritides (SpA) are a group of immune-mediated inflammatory diseases that affect the axial and peripheral skeleton as well as the skin, eye, and gut. Patients with SpA are at increased risk of developing certain comorbidities which may have adverse impacts on health outcomes and management of and may be associated with increased health care costs. Rheumatologists should be aware of comorbid conditions associated in order to provide comprehensive care to SpA patients. Common comorbidities include gastroduodenal ulcers, cardiovascular diseases including hypertension, myocardial infarction, and stroke, osteoporosis and vertebral fractures, sleep apnea, and lung disease.
KeywordsAnkylosing spondylitis Spondyloarthritis Comorbidity
Compliance with ethical standards
Conflict of interest
Dr. Abhijeet Danve declares no conflict of interest.
Dr. Siba Raychaudhuri declares no conflict of interest.
Human and animal rights and informed consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Source and grants
References and Recommended Reading
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 3.• Kang JH, Chen YH, Lin HC. Comorbidity profiles among patients with ankylosing spondylitis: a nationwide population-based study. Ann Rheum Dis. 2010;69(6):1165–8. Here, the authors have studied the prevalence and risk of comorbidities in patients with ankylosing spondylitis compared with the general population.CrossRefPubMedGoogle Scholar
- 5.• Molto A, Etcheto A, van der Heijde D, et al. Prevalence of comorbidities and evaluation of their screening in spondyloarthritis: results of the international cross-sectional ASAS-COMOSPA Study. Ann Rheum Dis. 2016;75(6):1016–23. This study informs about comorbidities in axSpA across multiple countries in different human races.CrossRefPubMedGoogle Scholar
- 8.•• Sherer Y, Shoenfeld Y. Mechanisms of disease: atherosclerosis in autoimmune diseases. Nat Clin Pract Rheumatol. 2006;2(2):99–106. Here, the authors have reviewed how autoimmune factors such as autoreactive lymphocytes or autoantibodies contribute to atherosclerosis in autoimmune rheumatic conditions.CrossRefPubMedGoogle Scholar
- 25.Calin A. Osteoporosis and ankylosing spondylitis. Br J Rheumatol. 1991;30(4):318–9.Google Scholar
- 37.Devogelaer JP, Maldague B, Malghem J, Nagant de Deuxchaisnes C. Appendicular and vertebral bone mass in ankylosing spondylitis. A comparison of plain radiographs with single- and dual-photon absorptiometry and with quantitative computed tomography. Arthritis Rheum. 1992;35(9):1062–7.CrossRefPubMedGoogle Scholar
- 40.Korkosz M, Gasowski J, Grzanka P, et al. Baseline new bone formation does not predict bone loss in ankylosing spondylitis as assessed by quantitative computed tomography (QCT): 10-year follow-up. BMC Musculoskelet Disord. 2011;12:121.Google Scholar
- 41.• Ward MM, Deodhar A, Akl EA, et al. American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis Rheumatol. 2016;68(2):282–98. Recommendations from ACR-SPARTAN-SAA to guide about management of comorbidities.CrossRefPubMedGoogle Scholar
- 46.Maas F, Spoorenberg A, van der Slik BP, et al. Clinical risk factors for the presence and development of vertebral fractures in patients with ankylosing spondylitis. Arthritis Care Res (Hoboken). 2016. doi: 10.1002/acr.22980.
- 61.•• Hellgren K, Dreyer L, Arkema EV, et al. Cancer risk in patients with spondyloarthritis treated with TNF inhibitors: a collaborative study from the ARTIS and DANBIO registers. Ann Rheum Dis. 2017;76:105–11. Excellent study about malignancy risk in AS.Google Scholar
- 62.Fouque-Aubert A, Jette-Paulin L, Combescure C, Basch A, Tebib J, Gossec L. Serious infections in patients with ankylosing spondylitis with and without TNF blockers: a systematic review and meta-analysis of randomised placebo-controlled trials. Ann Rheum Dis. 2010;69(10):1756–61.CrossRefPubMedGoogle Scholar
- 63.Wallis D, Thavaneswaran A, Haroon N, Ayearst R, Inman R. Infection risk in ankylosing spondylitis: results from a longitudinal observational cohort. Arthritis Rheum. 2013;65:1507.Google Scholar
- 68.Berdal G, Halvorsen S, van der Heijde D, Mowe M, Dagfinrud H. Restrictive pulmonary function is more prevalent in patients with ankylosing spondylitis than in matched population controls and is associated with impaired spinal mobility: a comparative study. Arthritis Res Ther. 2012;14(1):R19.CrossRefPubMedPubMedCentralGoogle Scholar
- 69.Jakobsen AK, Jacobsson LT, Patschan O, Askling J, Kristensen LE. Is nephrolithiasis an unrecognized extra-articular manifestation in ankylosing spondylitis? A prospective population-based Swedish national cohort study with matched general population comparator subjects. PLoS One. 2014;9(11):e113602.CrossRefPubMedPubMedCentralGoogle Scholar
- 73.•• Farber EM, Raychaudhuri SP. Concept of total care: a third dimension in the treatment of psoriasis. Cutis. 1997;59:35–9. Here, the authors have provided their original idea about the concept of total care for chronic inflammatory diseases, keeping psoriasis as the disease model.PubMedGoogle Scholar
- 74.• Raychaudhuri SP. Comorbidities of psoriatic arthritis—metabolic syndrome and prevention: a report from the GRAPPA 2010 annual meeting. J Rheumatol. 2012;39:437–40. This article provides the concept of total care for the treatment of comorbidities in psoriatic arthritis by rheumatologists in their day-to-day practice.Google Scholar