Real-life data on the comorbidities in spondyloarthritis from our multicenter nationwide registry: BioStar
H. Fatih Çay1
, Meltem Alkan Melikoğlu2, Fatma Gül Yurdakul3, Hatice Bodur3, Şebnem Ataman4, Erhan Çapkın5, Gülcan Gürer6, İlhan Sezer7, M. Tuncay Duruöz8, Aylin Rezvani9, İlker Yağcı10, Feride Göğüş11, Ayhan Kamanli12, Remzi Çevik13, Özgür Akgül14
1Department of Physical Medicine and Rehabilitation, Division of Rheumatology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Türkiye
2Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Atatürk University Faculty of Medicine, Erzurum, Türkiye
3Department of Physical Medicine Rehabilitation, Ankara City Hospital, Ankara, Türkiye
4Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Ankara University Faculty of Medicine, Ankara, Türkiye
5Department of Physical Medicine Rehabilitation, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye
6Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
7Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Akdeniz University Faculty of Medicine, Antalya, Türkiye
8Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Marmara University Faculty of Medicine, Istanbul, Türkiye
9Department of Physical Medicine Rehabilitation, Istanbul Medipol University, International Faculty of Medicine, Istanbul, Türkiye
10Department of Physical Medicine Rehabilitation, Marmara University Faculty of Medicine, Istanbul, Türkiye
11Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Gazi University Faculty of Medicine, Ankara, Türkiye
12Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Sakarya University Faculty of Medicine, Sakarya, Türkiye
13Department of Physical Medicine Rehabilitation, Dicle University Faculty of Medicine, Diyarbakır, Türkiye
14Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Manisa Celal Bayar University Faculty of Medicine, Manisa, Türkiye
Keywords: Charlson Comorbidity Index, comorbidities, Rheumatic Disease Comorbidity Index, Spondyloarthritis, BioStar.
Abstract
Objectives: Considering that the comorbid situations during the management of Spondyloarthritis (SpA) have been underlined in several recommendations, the main objective of this study was to evaluate the comorbid conditions of Turkish patients with SpA.
Patients and methods: This cross-sectional observational study was conducted with 1,242 SpA patients (844 males, 398 females; mean age: 43.9±11.0 years; range, 19 to 81 years) diagnosed according to the modified New York criteria for ankylosing spondylitis or the Assessment of SpondyloArthritis International Society (ASAS) criteria. The patient data were collected from the Biologic and targeted Synthetic antirheumatic drugs Registry (BioStar) between February 1, 2019, and December 29, 2020. Clinical and demographic data, including, age, sex, disease duration, body mass index (BMI), pain, patient’s global assessment, physician’s global assessment, Bath Ankylosing Spondylitis Disease Activity Index, Ankylosing Spondylitis Disease Activity Score, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, and Maastricht Enthesitis Score, were recorded. Comorbid conditions were recorded by filling out a questionnaire according to the clinical history or medical records. Charlson Comorbidity Index and Rheumatic Disease Comorbidity Index scores were calculated from the gathered comorbidity information.
Results: Nine hundred thirteen patients had radiographic axial SpA, 153 had nonradiographic axial SpA, and 176 had peripheral SpA. The most common comorbidities were hypertension (HT) (n=167, 13.4%), diabetes mellitus (DM) (n=83, 6.7%), thyroid disorders (n=64, 5.6%), and depression (n=61, 4.9%). The comorbidities and the calculated comorbidity indices were significantly higher in females, in those with a BMI >25 kg/m2 , and those over 60 years of age. No relationship was found between smoking and alcohol use and comorbidities. A significantly higher prevalence of HT and DM in peripheral SpA patients and a lower prevalence of thyroid disorders in radiographic axial SpA patients were observed.
Conclusion: The most commonly reported comorbidities were HT, DM, thyroid disorders, and depression in SpA patients according to the BioStar database. The frequency of comorbidities and composite comorbidity scores were higher among females, older (>60 years) patients, and overweight (BMI >25 kg/m2 ) patients.
Citation: Çay HF, Alkan Melikoğlu M, Yurdakul FG, Bodur H, Ataman Ş, Çapkın E, et al. Real-life data on the comorbidities in spondyloarthritis from our multicenter nationwide registry: BioStar. Arch Rheumatol 2023;38(3):333-346.
The study protocol was approved by the Ankara Numune Training and Research Hospital (Date/no: December 13th, 2018/E-182413) and Turkish Medicines and Medical Devices Agency Ethics Committee (Date/no: January 13th, 2019/66175679- 514.99-E.6366). The study was conducted in accordance with the principles of the Declaration of Helsinki.
A written informed consent was obtained from each patient.
Idea/concept: H.F.Ç., H.B.; Design, analysis and/or interpretation, literature review, writing the article, references: H.F.Ç.; Control/ supervision, critical review: M.A.M., H.B.; Data collection and/or processing: H.F.Ç., H.B., M.A.M., F.G.Y., .A., E.Ç., G.G., ‹.S., M.T.D., A.R., ‹.Y., F.G., A.K., R.Ç., Ö.A.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
This investigation is financially supported by Turkish League Against Rheumatism (TLAR).
The data that support the findings of this study are available from the corresponding author upon reasonable request.