Comorbidities in Spondyloarthritis
Comorbidities in spondyloarthritis (SpA) add to the burden of disease by contributing to disease activity, functional and work disability, and mortality. Thus, awareness of comorbidities in SpA is crucial to improve their screening and management and to ultimately improve outcomes in those affected....
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2018-03-01
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| Series: | Frontiers in Medicine |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fmed.2018.00062/full |
| _version_ | 1819242218991386624 |
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| author | Anna Moltó Anna Moltó Elena Nikiphorou Elena Nikiphorou |
| author_facet | Anna Moltó Anna Moltó Elena Nikiphorou Elena Nikiphorou |
| author_sort | Anna Moltó |
| collection | DOAJ |
| description | Comorbidities in spondyloarthritis (SpA) add to the burden of disease by contributing to disease activity, functional and work disability, and mortality. Thus, awareness of comorbidities in SpA is crucial to improve their screening and management and to ultimately improve outcomes in those affected. Osteoporosis has been reported to be the most prevalent comorbidity in SpA, and its risk is increased in these patients, compared with the general population; the risk of vertebral fractures requires further evaluation. Cardiovascular risk is also increased in this population, both due to an increase of the traditional cardiovascular risk factors in these patients, but also due to the presence of inflammation. The role of non-steroidal anti-inflammatory drugs in this increased risk needs further elucidation, but there is consensus on the need to encourage smoking cessation and to perform periodic evaluation of cardiovascular risk in these patients, particularly in the case of change in treatment course. Concerning the risk of cancer, no increased risk inherent to SpA seems to exist. However, an increased neoplastic risk can occur due to SpA treatments, e.g., P-UVA. Data are sparse on the risk of infections compared with rheumatoid arthritis, but there appears to be no risk in the absence of TNF-inhibitor exposure. Regardless of which comorbidity, a gap exists between recommendations for their management and actual implementation in clinical practice, suggesting that there is still a need for improvement in this area. Systematic screening for these comorbidities should improve both short- and long-term outcomes in SpA patients. |
| first_indexed | 2024-12-23T14:36:19Z |
| format | Article |
| id | doaj.art-5704d760cbde427f93f26ca86ddb09b4 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-23T14:36:19Z |
| publishDate | 2018-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-5704d760cbde427f93f26ca86ddb09b42022-12-21T17:43:21ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2018-03-01510.3389/fmed.2018.00062338356Comorbidities in SpondyloarthritisAnna Moltó0Anna Moltó1Elena Nikiphorou2Elena Nikiphorou3Rheumatology B Department, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, FranceINSERM (U1153) PRES Sorbonne Paris-Cité, Paris, FranceAcademic Rheumatology Department, King’s College London, London, United KingdomDepartment of Rheumatology, Whittington Hospital, London, United KingdomComorbidities in spondyloarthritis (SpA) add to the burden of disease by contributing to disease activity, functional and work disability, and mortality. Thus, awareness of comorbidities in SpA is crucial to improve their screening and management and to ultimately improve outcomes in those affected. Osteoporosis has been reported to be the most prevalent comorbidity in SpA, and its risk is increased in these patients, compared with the general population; the risk of vertebral fractures requires further evaluation. Cardiovascular risk is also increased in this population, both due to an increase of the traditional cardiovascular risk factors in these patients, but also due to the presence of inflammation. The role of non-steroidal anti-inflammatory drugs in this increased risk needs further elucidation, but there is consensus on the need to encourage smoking cessation and to perform periodic evaluation of cardiovascular risk in these patients, particularly in the case of change in treatment course. Concerning the risk of cancer, no increased risk inherent to SpA seems to exist. However, an increased neoplastic risk can occur due to SpA treatments, e.g., P-UVA. Data are sparse on the risk of infections compared with rheumatoid arthritis, but there appears to be no risk in the absence of TNF-inhibitor exposure. Regardless of which comorbidity, a gap exists between recommendations for their management and actual implementation in clinical practice, suggesting that there is still a need for improvement in this area. Systematic screening for these comorbidities should improve both short- and long-term outcomes in SpA patients.http://journal.frontiersin.org/article/10.3389/fmed.2018.00062/fullspondyloarthritiscomorbiditycardiovascularosteoporosisinfectioncancer |
| spellingShingle | Anna Moltó Anna Moltó Elena Nikiphorou Elena Nikiphorou Comorbidities in Spondyloarthritis Frontiers in Medicine spondyloarthritis comorbidity cardiovascular osteoporosis infection cancer |
| title | Comorbidities in Spondyloarthritis |
| title_full | Comorbidities in Spondyloarthritis |
| title_fullStr | Comorbidities in Spondyloarthritis |
| title_full_unstemmed | Comorbidities in Spondyloarthritis |
| title_short | Comorbidities in Spondyloarthritis |
| title_sort | comorbidities in spondyloarthritis |
| topic | spondyloarthritis comorbidity cardiovascular osteoporosis infection cancer |
| url | http://journal.frontiersin.org/article/10.3389/fmed.2018.00062/full |
| work_keys_str_mv | AT annamolto comorbiditiesinspondyloarthritis AT annamolto comorbiditiesinspondyloarthritis AT elenanikiphorou comorbiditiesinspondyloarthritis AT elenanikiphorou comorbiditiesinspondyloarthritis |