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Several recommendations for the screening and management of these comorbidities have been developed in recent years with the aim of improving the different outcomes in these patients. Osteoporosis is the most prevalent comorbidity in patients with SpA, mainly caused by systemic inflammation and a lack of mobility, while cardiovascular diseases explain the increased mortality in patients with SpA with regard to the general population. Data from randomised controlled trials show a low incidence of infections in both patients with and without immunosuppressive treatment, and no evidence of a high incidence of malignant diseases has been demonstrated in these patients. Finally, concomitant fibromyalgia deserves attention, since its coexistence with SpA leads to a poorer treatment response and more switches of anti-TNF treatments. In this review, we show an update of the most common comorbidities in patients with SpA, and we discuss the latest evidence on the management of such comorbidities.<\/jats:p>","DOI":"10.1136\/rmdopen-2019-001135","type":"journal-article","created":{"date-parts":[[2020,9,5]],"date-time":"2020-09-05T09:45:14Z","timestamp":1599299114000},"page":"e001135","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Comorbidity management in spondyloarthritis"],"prefix":"10.1136","volume":"6","clinical-trial-number":[{"clinical-trial-number":"nct02374749","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2309-5837","authenticated-orcid":false,"given":"Clementina","family":"L\u00f3pez-Medina","sequence":"first","affiliation":[{"name":"Rheumatology Department, H\u00f4pital Cochin - APHP Centre, Paris, France"},{"name":"ECAMO Team - INSERM (U1153) Clinical Epidemiology and Biostatistics PRES Sorbonne Paris-Cit\u00e9 Universit\u00e9 De Paris, Paris, France"},{"name":"Maim\u00f3nides Biomedical Research Institute of C\u00f3rdoba (IMIBIC), C\u00f3rdoba, Spain"},{"name":"Rheumatology Department, Reina Sof\u00eda University Hospital, C\u00f3rdoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2246-1986","authenticated-orcid":false,"given":"Anna","family":"Molto","sequence":"additional","affiliation":[{"name":"Rheumatology Department, H\u00f4pital Cochin - 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