Page 69 - SPONDYLOARTHRITIS IN COLOMBIA -

INTRODUCTION
Comorbidities are frequently associated with inflammatory rheumatic diseases such as ankylosing spondylitis (AS), psoriatic arthritis (PsA) and rheumatoid arthritis (RA). In addition to the musculoskeletal manifestations for SpA and SpA-related extra-articular features (psoriasis, uveitis, inflammatory bowel disease (IBD)), patients may also have an increased risk of cardiovascular (CV) events, metabolic syndrome, malignancies and infections1, 2, 3. These comorbidities may result in premature-death4.
The risk of developing comorbid conditions seems to be higher in patients with SpA than in the general population5, and these co-morbidities may manifest already shortly after the onset of initial symptoms6. CV events occur more frequently in AS patients, likely due to an increased prevalence of traditional risk factors (e.g. metabolic syndrome, arterial hypertension (AHT))7,8,9 and to the medications used for the treatment of SpA (e.g. non-steroidal anti-inflammatory drugs (NSAIDS). The increased risk of tuberculosis (TB) may be due to immune disturbances by the disease itself and by pharmacological immunosuppression10. Additionally, the risk of developing malignancies may be related to chronic inflammation and autoimmunity, although epidemiological evidence that AS is associated with the development of malignancy is lacking 11.
The Assessment of SpondyloArthritis international Society of COMOrbidities in SpA (ASAS- COMOSPA) study 12 is a cross-sectional observational study to assess comorbidities and their risk factors in SpA. This initiative included three Latin American (LA) countries, and provides an opportunity to explore the association of these comorbidities with SpA. While there are data in the
literature on comorbid conditions in SpA in other regions, this information is limited in LA countries. 67