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ethnic and demographic differences; therefore, the AHT data was analysed only for two countries. This limits the ability to extrapolate findings to the whole region. Second, the prevalence of some comorbidities might have been underestimated, because patients may have been unable to participate due to clinically relevant conditions. On the other hand, comorbidities might have been overestimated because of investigation bias: SpA patients with comorbidities that are known to be associated with the disease may be overrepresented in this sample. Finally, it is important to mention an additional source of potential bias in relation to TB-case-ascertainment: While the global TB report had been based on comprehensive data reported at the national level according to guidelines by the World Health Organization, in the COMOSPA study cases of TB had been ascertained by the patients and subsequent medical record review. These data do not necessarily yield the same results.
In conclusion, LA patients with SpA have an increased risk of developing AHT and TB compared with the general-population. These findings illustrate the need for optimal detection and monitoring of these conditions in SpA patients, and have implications for rheumatologist’s health assessments, prevention and treatment planning in LA countries.
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