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Comorbidity burden in psoriatic arthritis and its impact on disease measures

1 Departments of Clinical Immunology and Rheumatology, St. John's Medical College Hospital, Bangalore, Karnataka, India
2 Chanre Rheumatology and Immunology Research Centre, Bangalore, Karnataka, India
3 Department of Rheumatology, Columbia Asia Hospital, Bangalore, Karnataka, India
4 Arthritis Specialty Clinic, Hubli, Karnataka, India
5 Department of Rheumatology, Manipal Hospitals, Bangalore, Karnataka, India
6 Department of Rheumatology, Vikram Hospital, Bangalore, Karnataka, India
7 Department of Clinical immunology and Rheumatology, Narayana Health City, Bangalore, Karnataka, India
8 Department of Rheumatology, Sakra Hospital, Bengaluru, Karnataka, India
9 Department of Rheumatology and Clinical Immunology, SDM Medical College, Dharwad, Karnataka, India
10 Department of Rheumatology and Immunology, JSS Medical College, Mysore, Karnataka, India
11 Department of Rheumatology, Yenepoya Specialty Hospital, Mangalore, Karnataka, India
12 Department of Rheumatology, Apollo Hospital, Bengaluru, Karnataka, India
13 Departments of Clinical Immunology and Rheumatology, Mahaveer Jain Hospital, Bengaluru, Karnataka, India
14 Department of Rheumatology, Aster CMI Hospital, Bengaluru, Karnataka, India
15 Apollo BGS Hospital, Mysore, Karnataka, India
16 Department of Rheumatology, Fortis Hospital, Bengaluru, Karnataka, India
17 Department of Rheumatology, Sparsh Hospital, Bengaluru, Karnataka, India
18 Samarpan Health Centre, Bengaluru, Karnataka, India

Correspondence Address:
Vineeta Shobha,
Department of Clinical Immunology and Rheumatology, St John's Medical College Hospital, Sarjapur Road, Bengaluru - 560 034, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/injr.injr_29_22

Introduction: Comorbidities frequently accompany psoriasis and psoriatic arthritis (PsA) and add to the disease burden. We aimed to identify the comorbidity burden in patients with PsA and evaluate its impact on the disease activity measures in our geographic region. Methods: This was a multicenter, cross-sectional study involving consecutive PsA patients from 17 rheumatology centers. Their disease variables and comorbidities were recorded. Results: In 549 enrolled patients, the mean age was 39.2 (14.9) years, with male predominance (6:5). The mean duration of PsA was 63.1 (76.3) months and 232 (42.3%) patients had one or more comorbidities. Dyslipidemia was the most prevalent comorbidity, followed by hypertension (HTN) (19.8%) and diabetes (16.6%). About 39% of patients were overweight and 18% were obese. Smoking, ischemic heart disease, hypothyroidism, osteoarthritis, depression, anxiety, and fractures were seen in <5% of the cohort. Increasing age, longer duration of psoriasis, a family history of cardiovascular disease (CVD) or stroke, smoking, alcohol consumption, and higher waist circumference were associated with the presence of one or more comorbidities. Overall, 104 (18.9%) patients needed hospitalization for various comorbidities. Infections accounted for 59 (10.8%), of which skin (23) was the most common site, followed by urinary tract (6) and lung (4). Conclusions: More than 40% of PsA patients have comorbidities. Dyslipidemia, HTN, diabetes, and obesity were most prevalent, putting these patients at risk for CVDs. Active screening for these comorbidities is crucial for providing comprehensive care to these patients.

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