Patients with depression, hypertension in AS exhibit worse function, disease activity
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Patients with ankylosing spondylitis who exhibit depression and hypertension appear to demonstrate worse function and disease activity, according to data presented at EULAR 2022 Congress.
“Comorbidities are more common in ankylosing spondylitis compared to the general population, and they are associated with higher morbidity and mortality,” Jean Liew, MD, of Boston University Medical Center, told attendees during the virtual meeting. “However, different combinations of comorbidities with one another may have differential impacts on management of AS, as well as clinical outcomes.”
To investigate the association between various baseline comorbidities and disease function in patients with AS, Liew and colleagues examined the Prospective Study of Ankylosing Spondylitis cohort, a multicenter, prospective database of patients from four centers in the United States and one in Australia. Patients with AS aged 18 years or older who fulfilled criteria for disease classification between 2002 and 2020 were included in the analysis.
Comorbidities were only included if they were present in 1% or more of the study population, Liew said. Researchers presumed undocumented comorbidities to be absent if they were missing in fewer than 15% of patients and excluded them if they were missing in more than 50% of patients. Characteristic clusters were compared, and associations were investigated, using linear regression adjusted for age and sex.
The analysis included a total of 1,270 patients with AS, with an average symptom duration of 20.6 years. The most common characteristic was depression, present in 31.4% of patients. The second-most common, hypertension, was present in 26.1% of included patients. Meanwhile, uveitis was the most common extra-musculoskeletal manifestation, present in 30.4% of patients. The cluster indicating no comorbidities among included patients was “significantly younger, with lower symptom duration” (P < .001).
Additionally, female patients demonstrated a higher likelihood of being in the depression (OR = 2; 95% CI, 1.38-2.9) and uveitis (OR = 2.09; 95% CI, 1.41-3.11) groups, compared with clusters with no comorbidities. Comorbidity amounts and clusters with depression and hypertension were associated significantly with worse disease activity and functioning status.
“We were able to identify distinct comorbidity clusters in AS patients,” Liew said. “We saw that type of comorbidity is important, and again, highlighting that people in the depression group were associated with worse disease activity and function.”
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Karmacharya P, et al. Comorbidity clusters in ankylosing spondylitis and their association with disease activity and functional impairment: data from the PSOAS cohort. Presented at: EULAR 2022 Congress; June 1-4, 2022 (virtual meeting).
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