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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...

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Autores principales: López-Medina, Clementina, Molto, Anna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
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.
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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
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