OP0154 COMORBIDITY CLUSTERS IN ANKYLOSING SPONDYLITIS AND THEIR ASSOCIATION WITH DISEASE ACTIVITY AND FUNCTIONAL IMPAIRMENT: DATA FROM THE PSOAS COHORT

Background Comorbidities in ankylosing spondylitis (AS) occur more frequently than the general population and are associated with higher morbidity mortality. Some comorbidities may together, making one likely presence of another, different combinations have differential considerations for AS management outcomes. Objectives To examine association baseline disease activity functional status AS. Methods We used data from Prospective Study Of Ankylosing Spondylitis (PSOAS) cohort, a multicenter, prospective cohort five centers (4 US, 1 Australia). patients ≥ 18 years fulfilling mNY criteria (2002-20) were included. Patient-reported (N=28) extra-musculoskeletal manifestations (EMMs, N=2) within 3 enrollment (prespecified on case-report form) only those occurring ≥1% Undocumented assumed to be absent if missing <15% patients, >50% excluded. Comorbidity clusters identified using K-median clustering. The optimal number was determined scree plot sum squared errors “elbow” graph line. Baseline characteristics compared, associations measures (primary outcomes: ASDAS-CRP BASFI) examined linear regression adjusted age sex. Results There 1,270 included mean 44.6 ±14.3 years, 74.4% males, 81.2% whites. Mean symptom duration 20.6±5.6 81.6% HLA-B27 positive, CRP elevated 27.5% at baseline. Depression most prevalent comorbidity (31.4%) followed by hypertension (26.1%); uveitis common EMM (30.4%). depression (27%), no (22%), (21%), (20%), asthma/low bone mass (10%) (Figure 1). cluster significantly younger, lower (p<0.001). Females had odds being (OR=2.00, 95% CI 1.38- 2.90) (OR=2.09, 1.41-3.11) compared comorbidities. worse (Table Table 1. Age sex between clusters, 3, activity/ based Linear models. Cluster (depression ) (hypertension 4 (uveitis 5 (asthma, low Outcomes Coef (95% CI) 0.98 (0.78-1.18) 0.43 (0.18-0.68) 0.04 (-0.19-0.27) 0.16 (-0.12-0.44) BASFI (0-10) 1.92 (1.51-2.34) 1.00 (0.53-1.48) -0.03 (-0.49-0.42) 0.64 (0.076-1.20) Enthesitis count 1.17 (0.73-1.61) 0.73 (0.19-1.26) 0.18 (-0.32-0.68) 0.48 (-0.13-1.08) Swollen joint (0-44) 0.27 (-0.08-0.62) (-0.01-0.86) 0.31 (-0.09-0.71) -0.95 (-0.58-0.39) Tender (0-46) 1.24 (0.59-1.88) 0.44 (-0.34-1.23) 0.56 (-0.18-1.29) 0.34 (-0.55-1.23) BASDAI 2.30 (1.88-2.71) 0.88 (0.36-1.40) 0.30 (-0.17-0.78) 0.61 (0.03-1.19) Patient Global 2.25 (1.82-2.68) 0.76 (0.21-1.30) -0.22 (-0.71-0.27) 0.29 (-0.31-0.89) Pain 2.45 (1.95-2.94) (0.37-1.62) 0.19 (-0.38-0.75) (-0.54-0.85) Spinal pain 2.40 (1.89-2.91) 1.05 (0.41-1.70) (-0.16-1.01) (0.04-1.47) Figure PSOAS Conclusion Distinct cohort. In addition comorbidities, type seems important. seem function. Disclosure Interests Paras Karmacharya: None declared, Cynthia S. Crowson: Dilli Poudel: John M Davis III Consultant of: Dr. has received consulting fees and/or honoraria AbbVie Sanofi-Genzyme (less $10,000 each), Grant/research support from: research Pfizer., Alexis Ogdie served as consultant AbbVie, Amgen, BMS, Celgene, Corrona, Gilead, Janssen, Lilly, Novartis, Pfizer, UCB 10,000 grants Novartis Pfizer Penn Amgen Forward (grants 10,000)., Jean Liew grant/research (> $10,000), Michael Ward: Mariko Ishimori: Weisman UCB, GSK (< $10,000)., Matthew Brown: Mohammad Rahbar: Mark Hwang: D Reveille JDR Lilly Janssen unrelated this work., Lianne Gensler Eli GSK, $10,000).