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

Wilson Bautista-Molano; Robert Landewé; Rubén Burgos-Vargas; José Maldonado-Cocco; Anna Moltó; Filip van den Bosch; Rafael Valle-Oñate; Maxime Dougados; Désirée van der Heijde

doi:10.3899/jrheum.170520

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.

Authors

Wilson Bautista-Molano^{1

2}, Robert Landewé^{3

4}, Rubén Burgos-Vargas^{3

4}, José Maldonado-Cocco^{3

4}, Anna Moltó^{3

4}, Filip van den Bosch^{3

4}, Rafael Valle-Oñate^{3

4}, Maxime Dougados^{3

4}, Désirée van der Heijde^{3

4}

Affiliations

¹ From the Rheumatology Department, Leiden University Medical Center, Leiden, the Netherlands; School of Medicine, Universidad Militar Nueva Granada and Rheumatology Department, Hospital Militar, Bogotá, Colombia; Amsterdam Rheumatology and Clinical Immunology Center, Amsterdam; Zuyderland Medical Center Heerlen, Heerlen, the Netherlands; Servicio de Reumatología, Hospital General de México and Universidad Nacional Autónoma de México, Mexico City, Mexico; School of Medicine, Buenos Aires University and Argentine Rheumatologic Foundation Dr. Osvaldo Carcia Morteo, Buenos Aires, Argentina; Rheumatology B Department, Paris Descartes University, Cochin Hospital, AP-HP; INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité, Paris, France; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium. wilson.bautista@gmail.com.
² W. Bautista-Molano, MD, Rheumatology Department, Leiden University Medical Center, and School of Medicine, Universidad Militar Nueva Granada and Rheumatology Department, Hospital Militar; R. Landewé, MD, PhD, Amsterdam Rheumatology and Clinical Immunology Center, and Zuyderland Medical Center Heerlen; R. Burgos-Vargas, MD, Servicio de Reumatología, Hospital General de México and Universidad Nacional Autónoma de México; J. Maldonado-Cocco, MD, School of Medicine, Buenos Aires University and Argentine Rheumatologic Foundation Dr. Osvaldo Carcia Morteo; A. Moltó, MD, PhD, Rheumatology B Department, Paris Descartes University, Cochin Hospital, AP-HP, and INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité; F. van den Bosch, MD, PhD, Department of Rheumatology, Ghent University Hospital; R. Valle-Oñate, MD, School of Medicine, Universidad Militar Nueva Granada and Rheumatology Department, Hospital Militar; M. Dougados, MD, Rheumatology B Department, Paris Descartes University, Cochin Hospital, AP-HP, and INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité; D. van der Heijde, MD, PhD, Rheumatology Department, Leiden University Medical Center. wilson.bautista@gmail.com.
³ From the Rheumatology Department, Leiden University Medical Center, Leiden, the Netherlands; School of Medicine, Universidad Militar Nueva Granada and Rheumatology Department, Hospital Militar, Bogotá, Colombia; Amsterdam Rheumatology and Clinical Immunology Center, Amsterdam; Zuyderland Medical Center Heerlen, Heerlen, the Netherlands; Servicio de Reumatología, Hospital General de México and Universidad Nacional Autónoma de México, Mexico City, Mexico; School of Medicine, Buenos Aires University and Argentine Rheumatologic Foundation Dr. Osvaldo Carcia Morteo, Buenos Aires, Argentina; Rheumatology B Department, Paris Descartes University, Cochin Hospital, AP-HP; INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité, Paris, France; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium.
⁴ W. Bautista-Molano, MD, Rheumatology Department, Leiden University Medical Center, and School of Medicine, Universidad Militar Nueva Granada and Rheumatology Department, Hospital Militar; R. Landewé, MD, PhD, Amsterdam Rheumatology and Clinical Immunology Center, and Zuyderland Medical Center Heerlen; R. Burgos-Vargas, MD, Servicio de Reumatología, Hospital General de México and Universidad Nacional Autónoma de México; J. Maldonado-Cocco, MD, School of Medicine, Buenos Aires University and Argentine Rheumatologic Foundation Dr. Osvaldo Carcia Morteo; A. Moltó, MD, PhD, Rheumatology B Department, Paris Descartes University, Cochin Hospital, AP-HP, and INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité; F. van den Bosch, MD, PhD, Department of Rheumatology, Ghent University Hospital; R. Valle-Oñate, MD, School of Medicine, Universidad Militar Nueva Granada and Rheumatology Department, Hospital Militar; M. Dougados, MD, Rheumatology B Department, Paris Descartes University, Cochin Hospital, AP-HP, and INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité; D. van der Heijde, MD, PhD, Rheumatology Department, Leiden University Medical Center.

PMID: 29247152
DOI: 10.3899/jrheum.170520

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