Prevalence of Comorbidities and Risk Factors for Comorbidities in Patients With Spondyloarthritis in Latin America: A Comparative Study With the General Population and Data From the ASAS-COMOSPA Study

J Rheumatol. 2018 Feb;45(2):206-212. doi: 10.3899/jrheum.170520. Epub 2017 Dec 15.

Abstract

Objective: Increased risk of comorbidities has been reported in spondyloarthritis (SpA). The objective of this study was to determine the prevalence and risk of developing comorbidities in patients with SpA in 3 Latin American (LA) countries, and to compare that prevalence with the general population.

Methods: Data were analyzed from 390 patients with SpA enrolled in the Assessment of SpondyloArthritis international Society of Comorbidities in SpA study from Argentina, Colombia, and Mexico. Age- and sex-standardized prevalence (95% CI) was estimated for arterial hypertension (AHT), tuberculosis (TB), and malignancies. Age- and sex-specific data from the general population were obtained from the Cardiovascular Risk Factor Multiple Evaluation in Latin America (CARMELA) study for AHT, the Global TB report, and the GLOBOCAN project for malignancies. Data analyzed for AHT were confined to Colombia and Mexico. The prevalence in patients with SpA was compared with the prevalence in the general population per age- and sex-specific stratum, resulting in standardized risk ratios (SRR).

Results: In total, 64% of the patients with SpA were male, with a mean age of 45 years (SD 14.7). The most common comorbidities in the 3 LA countries were AHT (25.3%, 95% CI 21.2-30.0), hypercholesterolemia (21.5%, 95% CI 17.6-26.0), and osteoporosis (9.4%, 95% CI 6.8-12.9). AHT prevalence in Colombia and Mexico was 21.4% (95% CI 15.4-28.9) and was higher than the general population (12.5%, 95% CI 11.4-13.7), resulting in an SRR of 1.5. TB prevalence in the 3 LA countries was 3.3% (95% CI 1.8-5.7), which was significantly higher than in the general population (0.32%), leading to an SRR of 10.3. The prevalence of malignancies was not increased.

Conclusion: Patients with SpA in LA are at increased risk of AHT and TB in comparison to the general population. While this sample of patients may not be entirely representative of the patient population in each country, a systematic evaluation of these comorbidities in all patients with SpA still may help to monitor these conditions better.

Keywords: PREVALENCE; RISK FACTORS; SPONDYLOARTHRITIS.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Gastrointestinal Diseases / epidemiology
  • Humans
  • Hypercholesterolemia / epidemiology
  • Hypertension / epidemiology*
  • Latin America / epidemiology
  • Male
  • Middle Aged
  • Neoplasms / epidemiology*
  • Osteoporosis / epidemiology
  • Prevalence
  • Risk
  • Risk Factors
  • Spondylarthritis / epidemiology*
  • Tuberculosis / epidemiology*
  • Ulcer / epidemiology