Evaluation of the impact of a nurse-led program of systematic screening of comorbidities in patients with axial spondyloarthritis: The results of the COMEDSPA prospective, controlled, one year randomized trial

{Objective: To evaluate the impact of a nurse-led program of systematic screening for the management (detection/prevention) of comorbidities. Methods: Prospective, randomized, controlled, open, 12-month trial (NCT02374749). Participants: consecutive patients with axial Spondyloarthritis (axSpA) (according to the rheumatologist) The program: A nurse collected data on comorbidities during a specific outpatient visit. In the event of non-agreement with recommendations, the patient was informed and a specific recommendation was given to the patient (orally and in a with a detailed written report). Patients were seen after one year in a nurse-led visit. Treatment allocation: random allocation (i.e. either this program or an educational program not presented here and considered here as the control group). Main outcome:: change after one year of a weighted comorbidity management score (0 to 100 where 0= optimal management). Results: 502 patients were included (252 and 250 in the active and control groups, respectively): age: 47 +/- 12 years, male gender: 63%, disease duration: 14 +/- 11y. After one year, no differences were observed in a weighted comorbidity management score. However, the number of patients in agreement with recommendations was significantly higher in the active group for vaccinations (flu vaccination: 28.6% vs. 9.9%, p<0.01; pneumococcal vaccination:40.0% vs. 21.1%