AB0816 COMORBIDITY AND THE USE OF BIOLOGICAL THERAPY IN AXIAL SPONDYLOARTHRITIS, IS THERE ANY IMPACT?

Abstract

BackgroundSpondyloarthritis (SpA) is a chronic inflammatory rheumatism that can be associated with a lot of comorbidities. Comorbidity seems to be a factor that is can influence the treatment tactics.ObjectivesThe aims of our study were to describe the prevalence of commonly reported comorbidities in spondyloarthritis and to study the influence of comorbidity on the prescription of biological therapies in patients with SpA.MethodsA retrospective study was conducted in a single rheumatology hospital in Morocco, including patients diagnosed as having SpA according to ASAS criteria 2010, during a period of 9 years. Comorbidity data were obtained through careful examination of the history and medical records. The Charlson comorbidity index [1] calculated for every patient.Results375 patients were included in the study. 206 (54,9%) women, mean age 46.8±14,0 years. 105 patients were treated with biologic therapy (28%), in majority with TNF alpha inhibitors (99 patients). 188 (50,1%) patients had Charlson comorbidity index =1. The most common comorbidities were type 2 diabetes (12% patients), cancer (4,5%), chronic liver disease (2,9%), chronic kidney disease (2,1%), peptic ulcer (1,6%), ischemic heart disease (1,3%). Mean Charlson index was 1,14 ± 1,56 in total group; it was significantly lower in patients who were treated with biological therapy (0,6 ± 1,03) than in biologic naïve SpA (1,35 ± 1,68), p=0,0001. Biologics were prescribed in 66,7% of patients without comorbidities, in comparison with 17,1% of patients with Charlson comorbidity index = 1, 8,6% with Charlson comorbidity index = 2 and 6,8% of patients with Charlson index = 3 or more.ConclusionComorbidities are common in SpA and have a direct impact on the use of biological therapy. The development of therapeutic strategy for treating comorbid conditions is a must to achieve therapeutic goals in SpA.References[1]Charlson E M et al. A new method of classifying prognostic comorbidity in longitudinal studies:development and validation. J Chronic Dis. 1987;40(5):373-83.Disclosure of InterestsNone declared</jats:sec