Age, Gender, and Disease Duration as Key Determinants of Comorbidity Burden in Spondyloarthritis: A Multicentre Cross-Sectional Study

TL;DR

This study finds that age, gender, and disease duration strongly influence comorbidity rates in spondyloarthritis patients in India.

Contribution

The study identifies age as the strongest predictor of comorbidities in spondyloarthritis patients across India.

Findings

Comorbidities were significantly more frequent in patients over 50 years old compared to younger patients.

Older age was strongly associated with higher rates of diabetes, hypertension, and thyroid disorders.

Female gender and longer disease duration were also linked to specific comorbidities like thyroid disorders and diabetes.

Abstract

The burden of comorbidities associated with spondylarthritis (SpA) in India remains relatively unexplored, with most existing research limited to specific regions. This study aimed to evaluate the prevalence and patterns of comorbidities among SpA patients across India.

This multicentre, observational study was conducted at seven centres across India using data from the Indian Rheumatology Association database. Comorbidities were classified according to the ICD-10 Charlson Comorbidity Index. Patients were stratified into two age groups (>50 vs. ≤50 years). Statistical analyses included descriptive statistics, Fisher’s exact test, chi-square test, two-tailed t-test, and logistic regression to identify predictors of comorbidity.

Of 1,250 SpA patients (mean age 39.8 ± 13.3 years), 25% had comorbidities. The most common were hypertension (11.8%) and diabetes (8.5%), including 1.1% with complications. Comorbidities were significantly more frequent in patients >50 years (55.3%) vs ≤50 years (16.6%, P < 0.001). Older age was associated with higher rates of diabetes (24.5% vs. 4.0%), hypertension (32.6% vs. 6.0%), and thyroid disorders (9.5% vs. 2.8%) (P < 0.001 for all). Logistic regression revealed age as the strongest predictor for hypertension (P < 0.001, Wald = 101.3), diabetes (P < 0.001), hyperlipidaemia (P = 0.022), and thyroid disorders (P = 0.003). Female gender was associated with thyroid disorders (P < 0.001), and longer disease duration with diabetes (P = 0.022).

This study underscores a substantial comorbidity burden among Indian SpA patients, highlighting the need for comprehensive screening and management strategies, particularly in older patients and those with longer disease duration.