Page 78 - SPONDYLOARTHRITIS IN COLOMBIA -

DISCUSSION
The results of this study show that the prevalence and the risk of ATH and TB is increased in patients with SpA if compared to the age- and gender-adjusted general-population in LA. Of note, the prevalence and the risk to develop malignancies were not significantly increased in SpA patients in comparison to the reference population.
Studies assessing the prevalence of AHT in AS patients have yielded different results. These discrepancies could be explained by the heterogeneity of study populations investigated 20. A cross- sectional US analysis 21 of the risk factors of CV disease showed an increased prevalence ratio of AHT in AS (1.3 [95%CI 1.1-1.4]) compared with control subjects (27% vs. 22%). Similar rates were observed in patients with PsA in this study. In a recent Dutch study a higher prevalence of AHT, stratified by age and gender, was observed in AS patients (41%) than in the general population (31%) 22. Furthermore, a Canadian study has shown that AHT was more common in AS patients (23%) than in matched controls without AS (18%) 23. Our results are consistent with these studies, reporting a higher AHT prevalence in patients with SpA as compared to a reference population of non-SpA individuals. In contrast, a Swedish study did not find a substantial difference between AS patients and controls regarding AHT (32% vs 29%, respectively) 24. While chronic inflammation may have had a detrimental effect on endothelial function and may have accelerated the progression of atherosclerosis, the common use of NSAIDS that we found in the current study (72%) is a more likely explanation for the increased prevalence of AHT.
A significantly higher prevalence and risk of developing TB in patients with SpA was found. Genetic
factors favouring disease reactivation from latent TB or progression of the infection in addition to
conventional risk factors for TB (e.g., age, gender, socioeconomic status, and occupation) may
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