Background/Purpose: Spondyloarthritis(SpA) is characterized by axial, peripheral and extra-articular manifestation(EAMs). Its frequency depends on the series, being the psoriasis(Ps), uveitis and inflammatory bowel disease(IBD) the most frequent. Neoplasms and cardiovascular events(CVE) are the comorbidities which have the highest mortality.  The main target is to describe the prevalence of EAMs, neoplasms and CVE in a series of patients with SpA of a reference hospital.

Methods: Descriptive and retrospective study (January2003-December2017) of patients with SpA with biological therapy(BT). For the analysis, frequencies and percentages were used for qualitative variables, and mean and standard deviation(SD) for quantitative. Statistical analysis was performed with IBM SPSS.

Results: We studied 246 patients (74.4% males) with a mean age(SD) of 52.9(13.3)years. The types of SpA were: ankylosing spondylitis(AS) (50.8%), psoriatic arthritis(PsA) (41.1%), undifferentiated SpA (5.3%), non-radiographic axial Spa (1.2%), enteropathic arthritis (1.2%) and reactive arthritis (0.4%) (TABLE). In the diagnosis of SpA, age was 39.7(12)years, ESR 37.4mm1ªh, CRP 3.15mg/dL, DAS28 3.01 and BASDAI 4.9. Enthesitis was present in 28.9% and 23.2% presented dactylitis. At the final study visit, the average duration of the SpA was 158(106.7)months. In 130 patients (59.8%) one EAM was observed, and two in 17 patients (6.9%).

Ps was observed in 102 patients (41.5%) after a mean development of the SpA of 241.4(163)months. In 20 cases, Ps was paradoxical (55% with adalimumab and 15% infliximab). The most frequent form was plaques (75.5%) and palmoplantar localization (29.7%). Uveitis was observed in 41 patients (16.7%) after a mean development of the SpA of 109.5(73)months. The most frequent associations of uveitis were with AS (80.5%), men (70.7%) and HLAB27+ (87.8%). The pattern was anterior (100%), unilateral (87.8%) and acute (92.7%). 14 patients (34.1%) were with BT (35.7% etanercept, 28.6% infliximab, 21.4% adalimumab). The incidence rate was 5.5 cases of uveitis/100 person-years of follow-up. We found IBD in 21 patients (8.5%) after a mean development of the SpA of 165(118.1)months. Three of the 21 presented it with BT (2 etanercept and 1 infliximab). Other MEAs were observed in 25.6%: osteoporosis (20.6%), cardiac arrhythmias (15.7%) and nephropathy (16%). A CVE was observed after a mean period of SpA of 133(115)months in 6.9% of the patients with an average CRP of 1,64mg/dL. Neoplasms were observed in 7.3% of the patients (66.7% were solid tumors (58.3% urothelial and 25% breast) and 27.8% lympropoliterative).

Conclusion: The AS and the PsA were the most frequent SpA in our series. The appearance of at least one EAM was observed in 60% of the patients, being a significant proportion (46.3%) before to the diagnosis of SpA. The frequency of CVE and neoplasm seems similar to the population.