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Previous studies in LA have assessed the prevalence rates of comorbid conditions, especially in RA. A systematic literature review evaluating CV risk factors in RA patients 28 found that AHT was the most common finding in almost all studies performed in the region, with an overall prevalence of 28% (range 11.2% to 80.6%). In our study, we found a prevalence of AHT in SpA patients of 25.3%, in the three LA countries, which was higher than expected from the general population but still lower than the prevalence reported in RA. This finding is consistent with the data observed in AS patients, in whom CV risk factors are less manifest than in RA8. Regarding TB data in LA, a recent prospective Brazilian study of patients with chronic inflammatory arthritis including AS, RA and PsA has suggested that patients who start TNF blockers have a significantly higher rate of active TB than healthy-controls (87 vs 36/100,000 person-years) 29.
This study has limitations. First, the sample of patients may not be generalizable to the patient population in each country or the whole region. This cohort may not have been fully representative of all SpA patients in the participating countries; moreover, the sample was rather small (especially for Colombia and Mexico) and limited to those patients that had access to specialized rheumatology care in academic centers. In particular, the higher educational status in Mexico and Colombia gives rise to the suggestion that the sample that was investigated may not be entirely representative of the population of SpA patients in these countries. This should be taken into account when interpreting the results.
In addition, the patients in this study were from only three LA countries, namely those that participated in the international ASAS-COMOSPA-study. Moreover, data of Argentina with regard to AHT was not included in the analyses for comparison to general population and calculation of SRR.
It was mainly due to a high inter-country variability of data in the general population as a result of 78