Prevalence and impact of comorbidities in axial spondyloarthritis: systematic review and meta-analysis



Zhao, Sizheng Steven ORCID: 0000-0002-3558-7353, Robertson, Selina, Reich, Tzvi, Harrison, Nicolas L, Moots, Robert J ORCID: 0000-0001-7019-6211 and Goodson, Nicola J ORCID: 0000-0003-0714-3568
(2020) Prevalence and impact of comorbidities in axial spondyloarthritis: systematic review and meta-analysis. RHEUMATOLOGY, 59 (Suppl4). pp. 47-57.

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Abstract

<h4>Objectives</h4>Comorbidities are common in people with axial spondyloarthritis (axSpA). In this systematic review and meta-analysis, we aimed to: (i) describe the prevalence of commonly reported comorbidities, (ii) compare comorbidities between axSpA and control populations, and (iii) examine the impact of comorbidity burden on axSpA outcomes.<h4>Methods</h4>We systematically searched Medline, PubMed, Scopus and Web of Science using a predefined protocol in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. We excluded studies of only one comorbid condition or a few closely related diseases within one organ system. Where possible, meta-analysis was performed using random-effects models.<h4>Results</h4>A total of 40 studies were included for analysis. 36 studies reported prevalence of comorbidities, amounting to a combined sample size of 119 427 patients. The number of comorbidities studied ranged from 3 to 43. The most prevalent individual comorbidities were hypertension (pooled prevalence 23%), hyperlipidaemia (17%) and obesity (14%). Eleven studies consistently showed higher prevalence of comorbidities in axSpA than controls, particularly large differences were seen for depression [pooled odds ratio (OR) 1.80] and heart failure (OR 1.84). Comorbidities (total number of and individual conditions) were also associated with axSpA disease activity, functional impairment, quality of life, work productivity and mortality.<h4>Conclusions</h4>Comorbidities are common in axSpA, particularly cardiovascular diseases and risk factors. Most comorbidities were more prevalent in axSpA patients than in control populations. Overall comorbidity burden, and many individual conditions, were associated with axSpA outcomes including worse disease severity, work productivity and mortality.

Item Type: Article
Uncontrolled Keywords: Ankylosing spondylitis, axial spondyloarthritis, comorbidity, multimorbidity, systematic review, meta-analysis
Depositing User: Symplectic Admin
Date Deposited: 02 Nov 2020 10:26
Last Modified: 18 Jan 2023 23:25
DOI: 10.1093/rheumatology/keaa246
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3105592