AB0723 Technical aids agreed among specialists for the management of comorbidity in patients with axial spondyloarthritis: the gecoax project

Abstract

BackgroundThe management of comorbidity in patients with axial spondyloarthritis (Ax-SpA) needs improvement; the implementation of clinical practice guidelines is still deficient and heterogeneous.ObjectivesTo prioritise comorbidities in Ax-SpA and to elaborate practical aids for their identification and follow-up.MethodsA multidisciplinary panel [10 rheumatologists (6 experts in Ax-SpA), 2 family doctors, 1 internist, 1 cardiologist, 1 gastroenterologist, 1 psychologist and 3 methodologists] prioritised, in a discussion group, a list of comorbidities based on frequency and impact. Each comorbidity was discussed largely and systematic reviews were performed to support or discard items. In a second meeting, items to be included were presented, discussed, and those with lower priority disregarded.ResultsThe panel produced a checklist for health professionals and another for patients. Each item is supported by arguments and references. Table 1 shows, schematically, the items included in the checklists.Table 1.Items included in the checklistUsual treatmentOf note: oral anticoagulants, antihypertensive drugs, ASA, steroids and NSAIDs. Specific comorbiditiesHypertension, heart failure, renal failure, liver cirrhosis, gastric ulcer, infections, tuberculosis, neurological disease, and fracture risk.Vaccine schedule and dental hygienePatient's vaccination status; prevention of infections.Life-stylePhysical activity (amount and type).Alcohol consumption. Detect possible abuses; important risk factor for other comorbidities.Depression, quality of sleep and sexual lifeThe impact of Ax-SpA in the psychosocial sphere is relevant and should be carefully evaluated. Specific questionnaires are recommended.Non-preventable diseasesFrequent association with uveitis, inflammatory bowel disease and cardiac pathology; systematise questionsConclusionsThese checklists are intended to facilitate the systematic evaluation of co-morbidity associated with Ax-SpA, thus allowing an earlier detection and better control and management of these patients by the rheumatologist.AcknowledgementsThis project was funded by Merck Sharp & Dohme Spain. Merck Sharp & Dohme had no influence on either the development of the project or the final content of the abstract.Disclosure of InterestNone declared