SAT0347 COMORBID CONDITIONS ARE ASSOCIATED WITH HIGHER DISEASE ACTIVITY AND WORSE FUNCTIONAL STATUS IN AXIAL SPONDYLOARTHRITIS: A POPULATION-BASED ANALYSIS OF INSURANCE CLAIMS LINKED TO PATIENT SURVEY DATA
Authors: Imke Redeker, Johanna Callhoff, Falk Hoffmann, Hildrun Haibel, Joachim Sieper, Angela Zink, Denis Poddubnyy
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Data on the prevalence of comorbidities and their association with disease activity and functional status in axial spondyloarthritis (axSpA) are scarce. <h3>Objectives:</h3> The aim of this study was to investigate the prevalence of comorbid conditions and to analyse their association with disease activity and functional status in a population-based cohort of patients with axSpA. <h3>Methods:</h3> A stratified random sample of subjects with a diagnosis of axSpA (ICD-10 M45) was drawn from health insurance data in Germany and received a questionnaire on disease-related, demographic and socioeconomic parameters. A sex- and age-matched control cohort without axSpA was drawn from the claims data. Information on comorbidities, drug prescriptions and non-pharmacological treatment was retrieved from claims data and linked to the questionnaire data for axSpA. Multivariable linear regression models were used to determine the association of comorbidities (defined by Elixhauser coding algorithms excluding rheumatic diseases) with disease activity and functional status. <h3>Results:</h3> A total of 1,776 patients with axSpA were included in the analyses; mean age was 56.1 years and 46.4% were female. The most prevalent comorbid conditions were hypertension (50.9%), depression (25.5%), and chronic pulmonary disease (23.4%) (Figure 1). The prevalence of the majority of comorbidities was higher in axSpA as compared to controls. In the multivariable linear regression analyses, the number of comorbidities was significantly associated with both BASDAI and BASFI: each comorbidity was associated with BASDAI increase by 0.12 and BASFI increase by 0.10 points independently of other factors including treatment (Table 1). <h3>Conclusion:</h3> Comorbid conditions are common in axSpA patients and are independently associated with higher disease activity and higher level of functional impairment. Higher disease activity and a higher level of functional disability might be indicators of a severe disease resulting in the development of comorbid conditions. <h3>Acknowledgement:</h3> This work was supported by the Federal Ministry of Education and Research within the research network PROCLAIR (01EC1405). <h3>Disclosure of Interests:</h3> Imke Redeker: None declared, Johanna Callhoff: None declared, Falk Hoffmann: None declared, Hildrun Haibel: None declared, Joachim Sieper Consultant for: Abbvie, Böhringer Ingelheim, Janssen, Lilly, Merck, Mylan, Novartis, Pfizer, UCB., Speakers bureau: Abbvie, Böhringer Ingelheim, Janssen, Lilly, Merck, Mylan, Novartis, Pfizer, UCB., Angela Zink Speakers bureau: Speakers fees from AbbVie, Janssen, Pfizer, Roche, Sanofi, Denis Poddubnyy Grant/research support from: AbbVie, Merck Sharp &amp; Dohme, Novartis, Consultant for: AbbVie, Bristol-Myers Squibb, Janssen, Merck Sharp &amp; Dohme, Novartis, Pfizer, UCB Pharma, Speakers bureau: AbbVie, Bristol-Myers Squibb, Janssen, Merck Sharp &amp; Dohme, Novartis, Pfizer, Roche, UCB Pharma