AB1228 COMPARATIVE ANALYSIS OF COMORBID PATHOLOGY IN PATIENTS WITH RHEUMATOID ARTHRITIS AND ANKYLOSING SPONDYLITIS
Authors: T. Raskina, O. Malyshenko, E. Usova, M. Letaeva, J. Averkieva
Journal: Annals of the Rheumatic Diseases (2020)

Background: Interest in comorbid conditions in rheumatoid arthritis (RA) and ankylosing spondylitis (AS) is due to their influence on the course and prognosis of the disease itself, the quality of life of patients and the choice of treatment tactics. Objectives: To compare the frequency and structure of comorbid pathology in patients with RA and AS. Methods: 130 cases of patients with RA (95 women, 35 men, average age 47±6.6 years) and 86 with AS (27 women and 59 men, average age 44 ±7.4 years) were analyzed. The effect of concomitant pathology on the long-term prognosis was evaluated using the Charlson comorbidity index. Results: Patients with RA had a combined pathology in 93.0% (122) cases, of which 24.5% (30) – one, 28.6% (35) – two, 46.7% (57) – three or more concomitant diseases. Concomitant diseases in AS patients were registered in 83.7% (72) of cases, including one in 36% (31), two in 14% (12), and three or more in 33.7% (29). The Charlson index from 1 to 2 points was determined in 78.5% (102) of RA patients and in 77.9% (69) of patients with AS (p=0.067). Values from 3 to 4 points had 19.2% (25) and 20.9% (18) of patients, respectively (p=0.064). The Charlson index of more than 5 points was registered in 2.3% (3) patients with RA and 1.2% (1) patients with AS. The leading place in the structure of comorbidity in the group of patients with RA was occupied by diseases of the digestive system, which was observed in 79.2% (103) of patients. In the second place in the same group were registered cardiovascular diseases (CVD) – in 48.5% (63) patients, the most common arterial hypertension – in 36.9% (48). 27.6% (36) of patients had chronic pyelonephritis in combination with urolitiasis. Osteoporosis was detected in 20.0% (26) of RA patients. In the group of patients with AS, diseases of the digestive system were also most frequently registered – in 76.7% (66) of patients. CVD was observed in 41.9 % (36) patients, of which 39.5% (34) had hypertension. Kidney diseases were registered in 9.3% (8) of patients. Osteoporosis was detected in 32.5% (28) of patients with AS. Comparative analysis of the structure and frequency of diseases of the digestive system in RA and AS revealed no significant differences. CVD was registered more often in RA than in AS (48.5% vs 41.8%, p=0.037). There were significant differences in the frequency of hypertension in the study groups of patients: hypertension was observed more often in patients with as in 39.5% of cases, while in RA only in 36.9% (p=0.041), which is probably due to long-term use of medium and high doses of NSAIDs as “basic therapy” for AS. Kidney diseases were more common in RA than in AS (27% vs 9.3%, p=0.022). Osteoporosis, in contrast, was most frequently detected in patients with AS than in RA patients (32.2% vs 20%, p=0.047). Conclusion: Despite differences in the pathogenesis of RA and AS, the long-term prognosis, determined by both rheumatic disease and comorbidities, did not differ significantly. Concomitant pathology is an important component that determines the management of patients. Disclosure of Interests: None declared