Background/Purpose: The presence of comorbidities in patients with rheumatic diseases affects functional capacity and quality of life, but also they can limit the therapeutic approach of the disease. Our purpose was to analyze the frequency of comorbidities in patients with Axial Spondyloarthritis (axSpA) and to assess their influence on different aspects of the disease.

Methods: Patients ≥18 years old diagnosed with axSpA (mNY 1987 and/or ASAS 2009 criteria) belonging to ESPAXIA (Estudio de Espondiloartritis Axial IREP Argentina) cohort were included. Demographic data, disease duration, and current treatment were collected. Pain, patient global assessment (VAS), disease activity (BASDAI), functional capacity (BASFI), enthesitis (MASES), axial mobility (BASMI), quality of life (ASQoL) and radiological damage (mSASSS) were assessed. The presence of comorbidities was evaluated and the Charlson comorbidity index was calculated.

Results:  204 patients were included, 74% were male, median age 46 years (IQR 35-57) and median disease duration 19 years (IQR 9-29). Seventy-three patients (35.8%) had at least one comorbidity, being the most common: cardiovascular (40.7%), gastrointestinal (38.7%), endocrine (16.2%), hepatobiliary (11.3%) and respiratory disease (9.3%). Patients with comorbidities were significantly older (56.9±13.6 yrs vs 41.4±12.1 yrs p= 0.0001) and had longer disease duration (26.9±14.4 yrs vs 16.8±11.2 yrs, p= 0.0001). After adjusting for these confounders, patients with comorbidities had worse functional capacity (mean BASFI 4.8± 2.9 vs 3.3± 2.8, p = 0.0001), lower quality of life (mean ASQoL 7.4±5.6 vs 5.8± 5.1, p= 0.02) and higher radiological damage (mean mSASSS 40.4±25.2 vs 20.4±21.7, p = 0.001). In multiple regression analysis, the presence of comorbidities remained significantly associated with worse functional capacity and quality of life. When we divide patients according to the number of comorbidities; 49 (24%) had one comorbidity, 18 (8.8%) two comorbidities and 6 (2.9%) three or more comorbidities, however, the number of comorbidities did not modify our findings. 

Conclusion: 35.8% of patients with axSpA presented comorbidities and that was associated with worse functional capacity, poor quality of life and greater radiographic damage, regardless of the number of comorbidities present.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/prevalence-of-comorbidities-in-patients-with-axial-spondyloarthritis-and-its-association-with-aspects-of-the-disease/