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Comorbidity management in spondyloarthritis
Comorbidities are defined as coexistent clinical disorders that appear as a consequence of persistent inflammatory activity and/or treatment. Comorbidities in spondyloarthritis (SpA) are frequent, contributing to a poorer quality of life, higher mortality and incremented healthcare costs. Several re...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7508211/ https://www.ncbi.nlm.nih.gov/pubmed/32892168 http://dx.doi.org/10.1136/rmdopen-2019-001135 |
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author | López-Medina, Clementina Molto, Anna |
author_facet | López-Medina, Clementina Molto, Anna |
author_sort | López-Medina, Clementina |
collection | PubMed |
description | Comorbidities are defined as coexistent clinical disorders that appear as a consequence of persistent inflammatory activity and/or treatment. Comorbidities in spondyloarthritis (SpA) are frequent, contributing to a poorer quality of life, higher mortality and incremented healthcare costs. Several recommendations for the screening and management of these comorbidities have been developed in recent years with the aim of improving the different outcomes in these patients. Osteoporosis is the most prevalent comorbidity in patients with SpA, mainly caused by systemic inflammation and a lack of mobility, while cardiovascular diseases explain the increased mortality in patients with SpA with regard to the general population. Data from randomised controlled trials show a low incidence of infections in both patients with and without immunosuppressive treatment, and no evidence of a high incidence of malignant diseases has been demonstrated in these patients. Finally, concomitant fibromyalgia deserves attention, since its coexistence with SpA leads to a poorer treatment response and more switches of anti-TNF treatments. In this review, we show an update of the most common comorbidities in patients with SpA, and we discuss the latest evidence on the management of such comorbidities. |
format | Online Article Text |
id | pubmed-7508211 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-75082112020-10-05 Comorbidity management in spondyloarthritis López-Medina, Clementina Molto, Anna RMD Open Spondyloarthritis Comorbidities are defined as coexistent clinical disorders that appear as a consequence of persistent inflammatory activity and/or treatment. Comorbidities in spondyloarthritis (SpA) are frequent, contributing to a poorer quality of life, higher mortality and incremented healthcare costs. Several recommendations for the screening and management of these comorbidities have been developed in recent years with the aim of improving the different outcomes in these patients. Osteoporosis is the most prevalent comorbidity in patients with SpA, mainly caused by systemic inflammation and a lack of mobility, while cardiovascular diseases explain the increased mortality in patients with SpA with regard to the general population. Data from randomised controlled trials show a low incidence of infections in both patients with and without immunosuppressive treatment, and no evidence of a high incidence of malignant diseases has been demonstrated in these patients. Finally, concomitant fibromyalgia deserves attention, since its coexistence with SpA leads to a poorer treatment response and more switches of anti-TNF treatments. In this review, we show an update of the most common comorbidities in patients with SpA, and we discuss the latest evidence on the management of such comorbidities. BMJ Publishing Group 2020-09-04 /pmc/articles/PMC7508211/ /pubmed/32892168 http://dx.doi.org/10.1136/rmdopen-2019-001135 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Spondyloarthritis López-Medina, Clementina Molto, Anna Comorbidity management in spondyloarthritis |
title | Comorbidity management in spondyloarthritis |
title_full | Comorbidity management in spondyloarthritis |
title_fullStr | Comorbidity management in spondyloarthritis |
title_full_unstemmed | Comorbidity management in spondyloarthritis |
title_short | Comorbidity management in spondyloarthritis |
title_sort | comorbidity management in spondyloarthritis |
topic | Spondyloarthritis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7508211/ https://www.ncbi.nlm.nih.gov/pubmed/32892168 http://dx.doi.org/10.1136/rmdopen-2019-001135 |
work_keys_str_mv | AT lopezmedinaclementina comorbiditymanagementinspondyloarthritis AT moltoanna comorbiditymanagementinspondyloarthritis |