Pain, comorbidity burden high in patients with spondyloarthritis
medwireNews: Results of two studies emphasize the important of taking pain and comorbidities into account when treating patients with spondyloarthritis (SpA).
In the first study, published in BMC Rheumatology, Swedish researchers assessed the prevalence of chronic pain in 940 SpA patients, of whom 61% had ankylosing spondylitis (AS) and 39% had undifferentiated SpA.
Overall, approximately a fifth (19.4%) of patients reported having chronic widespread pain during the previous year, and almost half (46.9%) had chronic regional pain, report Elisabeth Mogard (Lund University) and study co-authors.
In subgroup analyses, chronic widespread and regional pain were both significantly more common among patients with undifferentiated SpA compared with AS, with corresponding rates of 49.3% versus 45.3% and 21.9% versus 17.7%.
Women were significantly more likely than men to have experienced chronic widespread pain during the previous year (54.1 vs 41.2%), and in a multivariate analysis female sex was an independent predictor for experiencing this type of pain. Higher BMI and smoking were also identified as significant predictors of chronic widespread pain.
Pain “can complicate the evaluation of disease activity and response to treatment in patients with AS and [undifferentiated] SpA,” and these findings “highlight the importance of a thorough pain analysis included in the clinical examination,” conclude the researchers.
In the second study, Xue Song (Truven Health Analytics, Cambridge, Massachusetts, USA) and colleagues found that patients with AS were significantly more likely to experience comorbidities than those without the disease in an analysis of US national claims databases.
As reported in Clinical Rheumatology, the 6679 patients with AS had a significantly higher burden of comorbidities at the time of diagnosis than the 19,951 matched controls without AS, with mean Deyo–Charlson Comorbidity Index scores of 0.61 versus 0.50 points.
Furthermore, patients with AS were significantly more likely than controls to be diagnosed with new comorbidities including asthma (incidence rate: 1.37 vs 0.76 per 100 patient–years), cardiovascular disease (CVD; 14.36 vs 11.06 per 100 patient–years), and depression (6.05 vs 3.22 per 100 patient–years) over a mean of approximately 2 years of follow-up.
And in a multivariate analysis controlling for demographic and clinical characteristics, patients with AS were significantly more likely than controls to develop extra-articular manifestations of AS, including inflammatory bowel disease, psoriasis, and uveitis, as well as other comorbidities such as asthma, CVD, depression, and cancer.
“Understanding the frequency and risk for these diseases can assist providers with comorbidity screening and patient-management strategies,” write Song and colleagues.
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