THU0282 The impact of comorbidities on physical function in patients with ankylosing spondylitis (AS) and psoriatic arthritis (PSA) attending rheumatology clinics. (12th June 2018)

• Record Type: Journal Article
• Authors: Fernández-Carballido, C.; Martín-Martínez, M.; García-Gómez, C.; Castañeda, S.; González-Juanatey, C.; Sánchez, F.; García-Vicuña, R.; Erausquin, C.; Lopez-Longo, J.; Sánchez-González, M.; Corrales, A.; Quesada, E.; Chamizo, E.; Barbadillo, C.; Bachiller, J.; Cobo, T.; Turrión, A.; Giner, E.; Llorca, J.; González-Gay, M.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 359
• Page End: 359
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.4260
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Regardless of disease activity, functional status gets worse in patients with rheumatoid arthritis (RA) with comorbidities. However, the impact of comorbidities on physical function in ankylosing spondylitis (AS) and psoriatic arthritis (PsA) is less known. Objectives: To assess the impact of comorbidities on physical function (PF) in patients with AS and PsA. Methods: Analysis of the baseline visit from the ongoing multicentric, observational, prospective, CARMA study. Data from patients with AS and PsA were analysed. Two different adjusted multivariate models were performed, where PF was the dependent variable (BASFI in AS and HAQ in PsA) and the following independent variables: comorbidities, a proxy for the Charlson index (ChI) (minimum 0; maximum 11), sociodemographic, disease activity (ESR, CRP and BASDAI in AS; while SJC, TJC, CRP, ESR, DAS, dactylitis count and PASI in PsA) and duration, radiographic damage and treatments. Results are presented as β coefficients and p-values. Results: 738 patients with AS and 721 with PsA included (mean age at inclusion 48.1±11.7 and 51.8±12 years, respectively). AS patients: median BASFI 3.1 [interquartile range (IQR): 1.3–5.2], BASDAI 3.5 [IQR: 1.7–5.3], mean ChI 1.32±0.73. PsA patients: HAQ 0.4 [IQR: 0.0–0.9], DAS28 2.9 [IQR: 2.0–3.8], mean ChI 1.30±0.66. A ChI >1 found in 21% of the patients. Hypertension in 25.7% and 29.5%; hypercholesterolemia in 27% and 35.6% and diabetes in 7.6% and 9.2% of the patients with AS and PsA, respectively. Cardiovascular events occurred in 7.6% AS and 7.2% PsA, in most cases after the rheumatic disease diagnosis. Only patients with PsA with higher ChI showed worse adjusted physical function (β: 0.09; p=0.03). Also female sex (β: 0.03; p=0.001), obesity (β: 0.09; p=0.04), disease duration (β: 0.01; p=0.009), NSAIDs (β: 0.1; p=0.02), corticosteroids (β: 0.12; p=0.02) and biologics (β: 0.15; p=0.07) were associated with worse function in patients with PsA. In contrast, a higher educational level was associated with less disability. In patients with AS, thyroid disease (β: 1.19, p=0.002) and raised ESR (β: 0.01, p=0.010) were independently associated with function. Conclusions: The presence of comorbidities in patients with PsA is independently associated with worse physical function, similar to what happens in RA. Early detection and control may yield an integral management of the disease and better final outcomes. Disclosure of Interest: None declared