P175 Comorbidities in psoriatic arthritis: a systematic review and meta-analysis

Abstract Background/Aims Psoriatic arthritis (PsA) is a heterogeneous disease with numerous articular phenotypes and extra-articular disease features. Patients with PsA have a higher risk of developing comorbidities. Studies in other chronic rheumatic diseases have shown comorbidity burden to be associated with poorer outcomes. The aims of this systematic review and meta-analysis were to: 1) describe the prevalence of comorbidities in PsA, 2) compare the incidence and/or prevalence of comorbidities between PsA and control populations; and 3) examine the impact of comorbidities on PsA outcomes. Methods Medline, PubMed, Scopus, and Web of Science were systematically searched using a predefined protocol in accordance with PRISMA guidelines. Exclusion criteria included: studies with risk of being non-representative of general PsA populations, studies reporting only one comorbidity, studies reporting psoriatic disease manifestations and pathomechanistically related conditions and other inflammatory arthritides. Where possible, meta-analysis was performed using random-effects models. Results A total of 3817 publications were returned by the literature search. After exclusions and de-duplication, 39 studies remained. Sample sizes ranged from 32 to 35,061 with a total of 158,797 PsA patients. The most frequently studied comorbidities were diabetes (n = 32 studies), hypertension (31) and hyperlipidaemia (18). A meta-analysis for the prevalence of 21 commonly reported comorbidities was performed (table 1). The most prevalent comorbidities were hypertension (pooled prevalence 34%), metabolic syndrome (29%), obesity (27%), hyperlipidaemia (24%) and any cardiovascular disease (19%). Eleven studies compared comorbidities between PsA and control groups. All except three studies matched or adjusted for potential confounders such as age and sex. Virtually all individual comorbidities had higher incidence and prevalence in the PsA group. The comorbidities and effect estimates were too heterogeneous to permit meta-analysis. Five studies reported the impact of comorbidities on PsA outcomes. In most studies, PsA patients with comorbidity had greater pain, functional limitation, and poorer quality of life than those without. One study reported that metabolic syndrome-related comorbidities were significantly associated with TNFi discontinuation. P175 Table 1:Meta-analysis estimates for prevalence of individual comorbidities.No. of studiesNo. of individualsPooled prevalence95% confidence intervalI2, %RangeAny CVD124436919.47.8-34.11003.1-70.5Any IHD8296719.27.1-11.6970.6-18.2Angina358283.61.4-6.6941.9-5.1Myocardial infarction10176283.22.3-4.2871.3-8.1Heart failure8234551.31.0-1.7720.6-3.1Stroke15428722.81.5-4.5980.0-21.8PVD8446291.60.5-3.3990.0-6.2Hypertension318501434.228.6-40.21006.4-62.7Diabetes mellitus328997212.910.7-15.2992.0-34.1Hyperlipidaemia185981624.217.4-31.81002.9-79.8Obesity152789027.424.5-30.49512.7-39.8Metabolic syndrome5110928.814.0-46.2969.9-44.0Any GI disease5119769.97.9-12.0716.0-16.0Liver disease10732893.40.1-9.61000.0-26.5Any pulmonary disease66837012.36.3-19.81005.0-22.7COPD6125173.40-10.4991.1-17.3Depression149154111.97.4-17.21000.8-27.2Any cancer11636705.24.2-6.4961.5-9.2Renal disease8330512.50.8-4.9991.0-8.1Osteoporosis4182159.33.0-18.3993.8-14.0Thyroid disorders52531610.57.7-13.7940.6-15.0Stroke includes cerebrovascular accidents and transient ischaemic attacks. PVD, peripheral vascular disease; COPD, chronic obstructive pulmonary disease; GI gastrointestinal. Conclusion Comorbidities, particularly cardiometabolic disorders, were highly prevalent in PsA and more common than in controls. Comorbidities were associated with adverse disease features, but more research is needed on their impact on longitudinal clinical outcomes. Disclosure Z.J. Syrimi: None. S. Gupta: None. S.S. Zhao: None. D.M. Hughes: None.

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Gender differences in the impact of metabolic syndrome components on mortality in older people: A systematic review and meta-analysis

Nutrition Metabolism and Cardiovascular Diseases ◽

10.1016/j.numecd.2020.04.034 ◽

2020 ◽

Vol 30 (9) ◽

pp. 1452-1464 ◽

Cited By ~ 2

Author(s):

Giuseppe Sergi ◽

Marta Dianin ◽

Anna Bertocco ◽

Bruno M. Zanforlini ◽

Chiara Curreri ◽

...

Keyword(s):

Systematic Review ◽

Metabolic Syndrome ◽

Gender Differences ◽

Older People ◽

Meta Analysis ◽

The Impact ◽

Metabolic Syndrome Components

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Abstract 15598: Population Characteristics and Outcomes of Patients With Constrictive Pericarditis Undergoing Pericardiectomy in the Contemporary Era: A Systematic Review and Metaanalysis

Circulation ◽

10.1161/circ.142.suppl_3.15598 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Aspasia Tzani ◽

Ilias P Doulamis ◽

Andreas Tzoumas ◽

Dimitrios V Avgerinos ◽

Polydoros Kampaktsis

Keyword(s):

Systematic Review ◽

Cardiac Surgery ◽

Constrictive Pericarditis ◽

Operative Mortality ◽

Meta Analysis ◽

Population Characteristics ◽

Significant Heterogeneity ◽

Comorbidity Burden ◽

The Impact ◽

Post Cardiac Surgery

Introduction: Studies have described the changing landscape of patients with constrictive pericarditis (CP) in the modern era, however no systematic review or meta-analysis has been performed. Methods: We systematically searched the MEDLINE, Embase and Cochrane databases from their inception to April 1, 2020 for studies assessing the characteristics and outcomes patients with CP undergoing pericardiectomy. A meta-analysis was performed to assess the impact of CP etiology on outcomes. Results: We analyzed 27 eligible studies and 2114 patients. Etiology was most commonly idiopathic (50.2%), post-cardiac surgery (26.2%) and radiation (6.9%)(Figure 1A-B). Patients were mostly men (76%), with a mean age of 58 years and with advanced symptoms (NYHA III/IV 70.1%). Total pericardiectomy was preferred (85.8%) (Figure 1C-D) and concomitant cardiac surgery was relatively common (23.8%). Operative mortality was 6.9% and 5-year mortality was 32.7% (Table 1). Radiation and post-cardiac surgery patients had higher long-term risk for mortality respectively compared to idiopathic pericarditis (HR: 2.15; 95% CI: 1.21-1.36, p=.01 and HR: 3.21; 95% CI: 1.56-6.50, p<.01, respectively). Thirty percent of included studies had more than low bias. A sensitivity analysis did not result in changes in the results. Conclusions: Pericardiectomy is performed mostly in middle-aged men with advanced symptoms and low comorbidity burden and still carries a significant operative mortality. Radiation and post-cardiac surgery patients have a significantly higher risk compared to idiopathic. Several methodological issues and significant heterogeneity limit the generalization of these data.

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The impact of exercise training on fatigue in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis

Pulmonology ◽

10.1016/j.pulmoe.2020.02.004 ◽

2020 ◽

Vol 26 (5) ◽

pp. 304-313 ◽

Cited By ~ 2

Author(s):

Mara Paneroni ◽

Michele Vitacca ◽

Massimo Venturelli ◽

Carla Simonelli ◽

Laura Bertacchini ◽

...

Keyword(s):

Systematic Review ◽

Chronic Obstructive Pulmonary Disease ◽

Exercise Training ◽

Pulmonary Disease ◽

Meta Analysis ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

The Impact

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Prevalence of comorbidity in Chinese patients with COVID-19: systematic review and meta-analysis of risk factors

BMC Infectious Diseases ◽

10.1186/s12879-021-05915-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tingxuan Yin ◽

Yuanjun Li ◽

Ying Ying ◽

Zhijun Luo

Keyword(s):

Systematic Review ◽

Cardiovascular Disease ◽

Cerebrovascular Disease ◽

Meta Analysis ◽

Treatment Strategies ◽

Chinese Patients ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Underlying Diseases ◽

The Impact

Abstract Background Coronavirus disease 2019 (COVID-19) is an infectious disease characterized by cough, fever, and fatigue and 20% of cases will develop into severe conditions resulting from acute lung injury with the manifestation of the acute respiratory distress syndrome (ARDS) that accounts for more than 50% of mortality. Currently, it has been reported that some comorbidities are linked with an increased rate of severity and mortality among COVID-19 patients. To assess the role of comorbidity in COVID-19 progression, we performed a systematic review with a meta-analysis on the relationship of COVID-19 severity with 8 different underlying diseases. Methods PubMed, Web of Science, and CNKI were searched for articles investigating the prevalence of comorbidities in severe and non-severe COVID-19 patients. A total of 41 studies comprising 12,526 patients were included. Results Prevalence of some commodities was lower than that in general population such as hypertension (19% vs 23.2%), diabetes (9% vs 10.9%), chronic kidney disease (CKD) (2% vs 9.5%), chronic liver diseases (CLD) (3% vs 24.8%) and chronic obstructive pulmonary disease (COPD) (3% vs 8.6%), while some others including cancer (1% vs 0.6%), cardiovascular disease (6% vs 1.8%) and cerebrovascular disease (2% vs 0.9%) exhibited greater percentage in COVID-19. Cerebrovascular disease (OR = 3.70, 95%CI 2.51–5.45) was found to be the strongest risk factor in disease exacerbation, followed by CKD (OR = 3.60, 95%CI 2.18–5.94), COPD (OR = 3.14, 95% CI 2.35–4.19), cardiovascular disease (OR = 2.76, 95% CI 2.18–3.49), malignancy (OR = 2.63, 95% CI 1.75–3.95), diabetes (OR = 2.49, 95% CI 2.10–2.96) and hypertension (OR = 2.13, 95% CI 1.81–2.51). We found no correlation between CLD and increased disease severity (OR = 1.32, 95% CI 0.96–1.82). Conclusion The impact of all eight underlying diseases on COVID-19 deterioration seemed to be higher in patients outside Hubei. Based on different comorbidities, COVID-19 patients tend to be at risk of developing poor outcomes to a varying degree. Thus, tailored infection prevention and monitoring and treatment strategies targeting these high-risk subgroups might improve prognosis during the COVID-19 pandemic.

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Prevalence and impact of comorbidities in axial spondyloarthritis: systematic review and meta-analysis

Rheumatology ◽

10.1093/rheumatology/keaa246 ◽

2020 ◽

Vol 59 (Supplement_4) ◽

pp. iv47-iv57 ◽

Cited By ~ 2

Author(s):

Sizheng Steven Zhao ◽

Selina Robertson ◽

Tzvi Reich ◽

Nicolas L Harrison ◽

Robert J Moots ◽

...

Keyword(s):

Systematic Review ◽

Axial Spondyloarthritis ◽

Meta Analysis ◽

Work Productivity ◽

Comorbid Condition ◽

Random Effects Models ◽

Pooled Prevalence ◽

Comorbidity Burden ◽

Meta Analyses ◽

The Impact

Abstract Objectives Comorbidities are common in people with axial spondyloarthritis (axSpA). In this systematic review and meta-analysis, we aimed to: (i) describe the prevalence of commonly reported comorbidities, (ii) compare comorbidities between axSpA and control populations, and (iii) examine the impact of comorbidity burden on axSpA outcomes. Methods We systematically searched Medline, PubMed, Scopus and Web of Science using a predefined protocol in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. We excluded studies of only one comorbid condition or a few closely related diseases within one organ system. Where possible, meta-analysis was performed using random-effects models. Results A total of 40 studies were included for analysis. 36 studies reported prevalence of comorbidities, amounting to a combined sample size of 119 427 patients. The number of comorbidities studied ranged from 3 to 43. The most prevalent individual comorbidities were hypertension (pooled prevalence 23%), hyperlipidaemia (17%) and obesity (14%). Eleven studies consistently showed higher prevalence of comorbidities in axSpA than controls, particularly large differences were seen for depression [pooled odds ratio (OR) 1.80] and heart failure (OR 1.84). Comorbidities (total number of and individual conditions) were also associated with axSpA disease activity, functional impairment, quality of life, work productivity and mortality. Conclusions Comorbidities are common in axSpA, particularly cardiovascular diseases and risk factors. Most comorbidities were more prevalent in axSpA patients than in control populations. Overall comorbidity burden, and many individual conditions, were associated with axSpA outcomes including worse disease severity, work productivity and mortality.

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Acceptance, adherence and dropout rates of individuals with COPD approached in telehealth interventions: a protocol for systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-026794 ◽

2019 ◽

Vol 9 (4) ◽

pp. e026794 ◽

Cited By ~ 4

Author(s):

Saeed Mardy Alghamdi ◽

Tania Janaudis-Ferreira ◽

Rehab Alhasani ◽

Sara Ahmed

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Hospital Readmissions ◽

Dropout Rates ◽

Cochrane Library ◽

Chronic Obstructive ◽

Related Factors ◽

Obstructive Pulmonary Disease ◽

Randomised Control Trials ◽

The Impact

IntroductionTelehealth interventions have the potential of improving exacerbation and health outcomes for individuals with chronic obstructive pulmonary disease (COPD), by delivering care in between clinical visits. However, the precise impact on avoiding exacerbation and reducing the incidence of hospital readmissions remains inconclusive. This lack of knowledge on the effectiveness of telehealth for COPD care might be due to non-adherence or partial adherence to intervention programmes and/or the withdrawal of participants over the course of previous studies.ObjectivesTo conduct a systematic review of trials of telehealth interventions (including randomised control trials (RCT), crossover and pre-post studies) to: (1) estimate the acceptance, adherence and dropout rates; (2) identify the reasons for dropout from telehealth interventions among individuals with COPD; (3) evaluate the impact of trial-related, sociodemographic and intervention-related factors on the acceptance, adherence and dropout rates and (4) estimate the extent to which the acceptance, adherence and dropout rates impact outcomes in comparison with usual monitoring.Methods and analysisA systematic literature review of four databases from earliest records to November 2018 will be carried out using CINAHL, Medline (Ovid), Cochrane Library and Embase. Randomised and non-randomised control studies will be included, in addition to crossover and pre-studies post-studies comparing telehealth with standard monitoring among individuals with COPD only. Two independent reviewers will screen all relevant abstracts and full-text studies to determine eligibility, assess the risk of bias and extract the data using structured forms. If the included studies are sufficiently homogenous in terms of interventions, populations and objectives, a meta-analysis will be performed.Ethics and disseminationEthical considerations are not required for this research.Trial registration numberCRD42017078541.

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Systematic review and meta‐analysis on prevalence of metabolic syndrome in psoriatic arthritis, rheumatoid arthritis and psoriasis

International Journal of Rheumatic Diseases ◽

10.1111/1756-185x.14147 ◽

2021 ◽

Author(s):

Aravinthan Loganathan ◽

Narainraj Kamalaraj ◽

Carlos El‐Haddad ◽

Kevin Pile

Keyword(s):

Rheumatoid Arthritis ◽

Systematic Review ◽

Metabolic Syndrome ◽

Psoriatic Arthritis ◽

Meta Analysis ◽

Arthritis Rheumatoid

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Comparison of Telehomecare Interventions in Controlling Chronic Obstructive Pulmonary Disease (COPD): Protocol for a Systematic Review and Meta-analysis

Critical Comments in Biomedicine ◽

10.18502/ccb.v2i2.7395 ◽

2021 ◽

Author(s):

Zohreh Shoyukhi ◽

Arezoo Dehghani Mahmoodabadi ◽

Hamid Reza Dehghan

Keyword(s):

Systematic Review ◽

Chronic Obstructive Pulmonary Disease ◽

General Population ◽

Pulmonary Disease ◽

Data Extraction ◽

Meta Analysis ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Hospitalization Costs ◽

The Impact

Background: Chronic obstructive pulmonary disease (COPD) is considered the fourth main cause of mortality worldwide, affecting 10% of adults aged up to 40 years. Due to the growing elderly population and smoking, the global burden of COPD is expected to increase in the general population. Telemedicine may help patients with COPD to decrease exacerbation episodes and the associated costs. Moreover, Telehomecare (THC) may be considered as an alternative to cut down hospitalization costs and increase the patients’ comfort. Objectives: This study explains the methodology of a systematic review and meta-analysis designed to evaluate the impact of THC interventions on the control and management of COPD and its complications. Methods: To review all published studies comparing THC interventions in controlling COPD and its complications, all studies published in PubMed, Google Scholar, Scopus, ISI Web of Science, Cochrane databases, HTA EED, DARE, Embase, SID, Magiran will be searched until the end of 2021. Randomized controlled trials (RCTs), cluster RCTs, controlled clinical trials comparing telehealth with standard monitoring of COPD patients were included. Independent reviewers will review the abstracts and full-texts of all relevant studies for eligibility, risk of bias, and data extraction using structured forms. The meta-analysis will be performed for adequately homogenous studies regarding their populations, interventions, and objectives. Conclusion: The results of this systematic review and meta-analysis will provide useful information on the impacts of THC on COPD control. The evidence provided by this systematic review can be helpful for clinical specialists, public health policymakers, and the general population.

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The Impact of Helminth Infection on the Incidence of Metabolic Syndrome: A Systematic Review and Meta-Analysis

Frontiers in Endocrinology ◽

10.3389/fendo.2021.728396 ◽

2021 ◽

Vol 12 ◽

Author(s):

Claire Rennie ◽

Ritin Fernandez ◽

Sheila Donnelly ◽

Kristine CY McGrath

Keyword(s):

Systematic Review ◽

Type 2 Diabetes ◽

Metabolic Syndrome ◽

Helminth Infection ◽

Meta Analysis ◽

Human Populations ◽

The Metabolic Syndrome ◽

Metabolic Outcomes ◽

The Impact

BackgroundThere are a growing number of publications that report an absence of inflammatory based disease among populations that are endemic to parasitic worms (helminths) demonstrating the ability of these parasites to potentially regulate human immune responses. The aim of this systematic review and meta-analysis was to determine the impact of helminth infection on metabolic outcomes in human populations.MethodsUsing PRISMA guidelines, six databases were searched for studies published up to August 2020. Random effects meta-analysis was performed to estimate pooled proportions with 95% confidence intervals using the Review Manager Software version 5.4.1.ResultsFourteen studies were included in the review. Fasting blood glucose was significantly lower in persons with infection (MD -0.22, 95% CI -0.40- -0.04, P=0.02), HbA1c levels were lower, although not significantly, and prevalence of the metabolic syndrome (P=0.001) and type 2 diabetes was lower (OR 1.03, 95% CI 0.34-3.09, P<0.0001). Infection was negatively associated with type 2 diabetes when comparing person with diabetes to the group without diabetes (OR 0.44, 95% CI 0.29-0.67, P=0.0001).ConclusionsWhile infection with helminths was generally associated with improved metabolic function, there were notable differences in efficacy between parasite species. Based on the data assessed, live infection with S. mansoni resulted in the most significant positive changes to metabolic outcomes.Systematic Review RegistrationWebsite: PROSPERO Identified: CRD42021227619.

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