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Revista argentina de reumatología
Print version ISSN 0327-4411On-line version ISSN 2362-3675
Abstract
ALFARO, María Agustina et al. Frequency of comorbidities in patients with psoriatic arthritis and evaluation of the adherence of physicians to the treatment recommendations of the GRAPPA 2015 Guidelines. Rev. argent. reumatolg. [online]. 2022, vol.33, n.4, pp.205-214. ISSN 0327-4411. http://dx.doi.org/10.47196/rar.v33i4.688.
Introduction:
comorbidities are common in patients with psoriatic arthritis (PsA). The GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis) guidelines strengthen the choice of treatments according to them.
Objetives:
to describe the prevalence of comorbidities in patients with psoriatic arthritis according to Rheumatic Disease Comorbidity Index (RDCI) and to analyze the influence of them on disease activity, functional capacity and quality life and to assess adherence to GRAPPA 2015 treatment recommendations according to the presence of comorbidities.
Materials and methods:
adult patients with PsA (CASPAR criteria) from the RAPSODIA cohort were included. Sociodemographic and clinical characteristics, disease activity and current treatment were recorded. Comorbidities were assessed by the RDCI. Variables associated with RDCI≥1 were studied by multivariate analysis. Adherence to treatment recommendations in relation to the reported comorbidities was analyzed according to the 2015 GRAPPA guidelines.
Results:
a total of 170 patients were included. Patients with RDCI ≥1 were reported by 67.6%. These patients were older (57±13 years vs 48±13 years, p<0.0001), had a higher frequency of overweight or obesity (84.3% vs 67.3%, p=0.011), and had a poorer quality of life (PsAQoL 7.6±6.6 vs 5.2±6, p=0.025). The multivariate analysis showed an association between age and the use of NSAIDs with RDCI≥1. Contrary to GRAPPA recommendations, 70% of patients with heart disease were using NSAIDs. Moreover, about half of those with hepatic or kidney disease took NSAIDs or methotrexate.
Conclusions:
most patients with PsA presented at least one comorbidity. GRAPPA recommendations were not followed in a considerable number of patients.
Keywords : comorbidities; Rheumatic Disease Comorbidity Index; GRAPPA guidelines; psoriatic arthritis.