Comparison of Neck Muscle Thickness via Ultrasound in Patients with Ankylosing Spondylitis and Healthy Controls

Objective: This study evaluates the loss of balance and fall risk in patients with Ankylosing Spondylitis (AS), and assesses their relationship with disease activity, functional status, spinal mobility, quality of life and enthesitis score.Method: Included in the study were 50 AS patients who were diagnosed in accordance with the modified New York criteria, and 50 healthy volunteers of similar age and gender. For the AS patients, disease activity was assessed using the Bath Ankylosing Spondylitis Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score (ASDAS) C-reactive protein/Erythrocyte sedimentation rate (CRP/ESR); functional status was assessed using the Bath Ankylosing Spondylitis Functional Index (BASFI); spinal mobility was assessed using the Bath Ankylosing Spondylitis Metrology Index (BASMI); and quality of life was assessed using the Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL). Additionally, a Short form-36 (SF-36) was used to assess quality of life in both the AS patients and the healthy control group; while a Timed Up and Go-test (TUG), Functional Reach Test (FRT), Berg Balance Scale (BBS) and Tinnetti’s Falls Efficacy Scale (TFES) were used to assess balance and fall risk. Enthesitis in the AS patients was evaluated using Maastricht Ankylosing Spondylitis Enthesitis Score (MASES). Results: A comparison of the AS patients and the healthy controls in terms of BBS, FRT, TUG and TFES revealed balance loss and fall risk to be higher in the AS patient group, to a statistically significant degree (p<0.001). BBS, FRT, TUG and TFES were statistically significantly correlated with BASDAI, BASMI, BASFI, ASDAS-ESR, ASDAS-CRP and ASQoL in AS patients (p<0.05), while no statistically significant correlation was identified between BBS, FRT, TUG, TFES and MASES (p>0.05).Conclusions: Loss of balance and fall risk are higher in AS patients than in healthy individuals. Loss of balance and fall risk is associated with disease activity, poor functional status, limited spinal mobility and quality of life in AS patients. That said, there is no association between enthesitis score and loss of balance and fall risk in AS patients. These findings suggest that loss of balance loss and fall risk should be assessed in patients with AS.

Ankylosing spondylitis (AS) is a chronic disease characterized by inflammation of the spine and joints. This study aimed to examine the multifidus (MF) and erector spinae (ES) muscles in AS patients using magnetic resonance imaging (MRI), and to evaluate the clinical implications of muscle findings. This study included 43 patients and 40 matched controls. The total (TCSA), functional (FCSA), relative CSAs, and ratios of MF and ES muscles were compared between the groups. The Visual Analog Scale, Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Functional Index (BASFI), Ankylosing Spondylitis Disease Activity Score with CRP, Ankylosing Spondylitis Disease Activity Score with ESR, Bath Ankylosing Spondylitis Activity Index, and Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL) scores of AS patients were recorded. Comparisons between the two groups were made using the Student's t-test and the Mann-Whitney U test. The TCSAs of the MF and ES were similar in the two groups. In contrast, MF relative FCSA (p = 0.003), ES relative FCSA (p < 0.001), ES FCSA (p = 0.017), MF FCSA/TCSA (p < 0.001), and ES FCSA/TCSA (p < 0.001) were decreased in AS patients. ES FCSA/TCSA was negatively correlated with BASMI (r = - 0.369, p = 0.015), while MF FCSA/TCSA was negatively correlated with BASMI, BASFI, and ASQoL (r = - 0.395, p = 0.009; r = - 0.321 p = 0.036; r = - 0.387, p = 0.010, respectively). The paravertebral muscle morphology significantly deteriorates in AS patients, exhibiting decreased functional muscle areas and increased fatty degeneration.

FRI0299 EVALUATION OF ENTHESITIS INDICES AND RESPONSE TO BDMARD THERAPY IN PORTUGUESE PATIENTS WITH SPONDYLOARTHRITIS

BackgroundPreviously, many studies have evaluated quality of life (QoL) in patients with ankylosing spondylitis (AS), however, none of them specifically investigated the correlation between pain-related disability measured by Oswestry Disability Index (ODI) and QoL in AS patients. In addition, the correlation between global kyphosis (GK) in lateral plain radiographs and QoL in AS patients remains unclear up to now. Therefore, this study aimed to evaluate QoL and correlation with clinical and radiographic variables in AS patients, especially to figure out the relationship about the pain-specific disability measured by ODI, GK and QoL.MethodsFrom January 2008 to November 2015, two hundred and forty-five consecutive patients with an average age of 36.2 ± 10.9 years (range, 17–66 years) satisfying the Modified New York Criteria for AS from a single institution were enrolled. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI) and Bath Ankylosing Spondylitis Global score (BAS-G) were applied to assess the disease activity, functional status, spinal mobility and overall feeling of AS patients, respectively. ODI was recorded to evaluate low back pain-related disability. QoL was evaluated by the Short Form-36 (SF-36). According to global kyphosis (GK) measured on standing lateral full-spine radiographs, the patients were divided into two groups: mild kyphotic group (GK < 70°,n = 176) and severe kyphotic group (GK ≥ 70°,n = 69).ResultsThe scores of BASDAI, BASFI, BASMI and ODI had significant negative correlations with all SF-36 subscale scores (P < 0.01). BASFI and BASMI scores of severe kyphotic group were much higher than those of mild kyphotic group, respectively (P = 0.005 and P = 0.001, respectively) and the score of physical function (PF) subscale in severe kyphotic group was significantly higher than that in mild kyphotic group (P = 0.046) as well. Notably, the scores of ODI, BASFI and BASMI were the major predictors of PF subscale score of SF-36.ConclusionsPoor QoL is significantly correlated with high disease activity, poor functional status and decreased spinal mobility in AS. GK is significantly associated with functional status, spinal mobility and QoL in AS patients. ODI, BASFI and BASMI are the major predictors of PF subscale of SF-36.

The Oswestry Disability Index is considered the gold standard in the evaluation of disability in patients with chronic mechanical back pain. The aim of this study was to assess the applicability of Oswestry Disability Index in patients with ankylosing spondylitis and its relationship with disease assessment parameters for ankylosing spondylitis. A total of 100 patients diagnosed with ankylosing spondylitis were included in the study group. The control group consisted of 50 individuals with nonspecific low back pain. The Oswestry Disability Index and Bath Ankylosing Spondylitis Disease Activity Index were applied to both groups. In addition, the Visual Analog Scale, the Ankylosing Spondylitis Disease Activity Score C-Reactive Protein, the Ankylosing Spondylitis Disease Activity Score-the Erythrocyte Sedimentation Rate, the Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, and the Ankylosing Spondylitis Quality of Life scales were applied in the study group. the Erythrocyte Sedimentation Rate, C-Reactive Protein levels, and HLA-B27 analysis were noted as laboratory markers in ankylosing spondylitis patients. The scores of Oswestry Disability Index had a significant correlation with scores of Bath Ankylosing Spondylitis Disease Activity Index in ankylosing spondylitis patients (r=0.543) and in the control group (r=0.401). There was a significant correlation between the scores of Oswestry Disability Index and the Bath Ankylosing Spondylitis Functional Index (r=0.544), Bath Ankylosing Spondylitis Metrology Index (r=0.317), the Ankylosing Spondylitis Quality of Life (r=0.723), the Ankylosing Spondylitis Disease Activity Score-the Erythrocyte Sedimentation Rate (r=0.501), the Ankylosing Spondylitis Disease Activity Score C-Reactive Protein (r=0.530), Visual Analog Scale-Rest (r=0.476), and Visual Analog Scale-Activity (r=0.441) values in patients with ankylosing spondylitis. Evaluation of Oswestry Disability Index in conjunction with Bath Ankylosing Spondylitis Disease Activity Index may warn the physician to interpret high Bath Ankylosing Spondylitis Disease Activity Index scores in the context of mechanical pain. Therefore, the use of Oswestry Disability Index in patients with ankylosing spondylitis will be beneficial.

THU0073 The Relationship among Bone Turnover Markers, Vitamin D Levels, Disease Activity, Function and Quality of Life in Patients with Ankylosing Spondylitis

The aim of this study was to explore the impact of ankylosing spondylitis (AS) and the disease-related variables on the patients' sexual function according to the International Index of Erectile Function (IIEF) scoring system. A total of 70 sexually active male AS patients and 60 healthy controls were enrolled in this study. Their demographic data were evaluated, and the pain was assessed according to the visual analogue scale (VAS). Laboratory tests were conducted in order to measure the C-reactive protein (CRP) and erythrocyte sedimentation rates (ESR) of the patients. The disease activity was evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Functional statement was evaluated with the help of the Bath Ankylosing Spondylitis Functional Index (BASFI) and with the scores obtained from the spinal measurements with the Bath Ankylosing Spondylitis Metrology Index (BASMI). The Bath Ankylosing Spondylitis Radiology Index (BASRI) was used to evaluate the radiological damage. The disease-related quality of life was measured with the Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL). The anxiety and depression level of the patients was revealed through the Hospital Anxiety and Depression Scale (HADS). In comparison with the healthy control group, patients with AS had significantly lower scores in each of the 5 domains of the IIEF (p<0.0001). The BASDAI, BASFI, BASMI, BASRI, ASQoL, HADS scores and CRP levels were negatively correlated with IIEF (p<0.05). Orgasmic function and sexual desire scores were significantly lower in patients with peripheral arthritis (p<0.05). No significant correlation was observed with the disease duration, smoking status, pain (VAS), and ESR levels when the total scores and the scores from the domains of IIEF were compared. The multivariate regression analyses indicated that BASFI and BASMI were independently associated with the sexual function. The sexual function is impaired in male patients with AS. This impairment in the sexual function is especially correlated with the BASFI and BASMI among the clinical and laboratory parameters.

Backgrounds. Ankylosing Spondylitis (AS) is a chronic inflammatory autoimmune disease involving spine, peripheral joints, enthesis, and sometimes visceral organs. The prevalence of AS is estimated about 0.2~0.4%. Unfortunately, most AS Patients were mis-diagnosed and under-treated due to their unrecognized disease conditions. Genetics of AS is highly related to a human leukocyte antigen, HLA-B27. The frequency of HLA-B27 in the Chinese population is 4%-9%. Basic science of AS was not well understood, but the immunology and treatment of AS have achieved great advances in the past few years. There are still many unmet needs in the pathogenesis and management of AS. There are still no useful or specific biomarkers for AS. For clinical evaluation, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Global Score (BAS-G) have been well accepted for evaluating function and disability in patients with ankylosing spondylitis (AS). However, there is no validated Chinese version of these instruments yet. Hence, a comprehensive AS database including clinical parameters and tissue samples is crucial and essential for future researches in Taiwan. Purposes. 1.To establish a database of clinical information as well as tissue samples in patients with AS in Taiwan. 2.To validate the Chinese version of BASDAI, BASFI and BAS-G indices. 3.To analyze epidemiological, genetic and serological parameters using this database. Methods. During Jan 2002 to Dec 2006, we created and performed a comprehensive questionnaire for every first visit AS patients in Chung Shan medical university. Serum were separated within 2 hours and stocked into -80 degree. Peripheral blood mononuclear cells (PBMC) were separated and stored in liquid nitrogen. DNA and RNA were extracted and stocked into -20 degree refrigerators. Psochometric validation of the Chinese version of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Global Index (BAS-G) were performed. The Bath indices and physical examination parameters were evaluated simultaneously when blood samples were obtained. For AS patients with positive HLA-B27, subtyping for 12 subtypes was done by PCR-SSO methods. For AS patients with negative HLA-B27, complete HLA-ABC typing was done by lymphocytotoxicity assay. Erythrocyte sedimentation rate (ESR), Hypersensitive C-reactive protein (HS-CRP) and Immunoglobulin A (IgA) were measured and compared the Bath clinical indices. Statistics: SAS for Windows was used for the statistical analyses. Comparisons were made using Student’s t-test for continuous variables and the c2 test for discrete variables. Reliability of our Chinese versions of the BASDI, BASFI, and BAS-G was tested by internal consistency and test-retest reliability. Internal consistency of the instrument was given as Cronbach’s alpha. Test-retest reliability was assessed by intraclass correlation coefficient. Correlations between BASDAI, BASFI, and BAS-G with laboratory and clinical assessments were also evaluated with Spearman’s rank correlation coefficient. For the case-control study, phenotype frequencies between patients and controls were assessed by the uncorrected c2 test. Haplotype frequencies in the control samples were determined using the program ‘Phase’. Only haplotypes with >90% probability were considered in linkage disequilibrium calculations. The presence of significant linkage disequilibrium was tested using Fisher’s exact test. Significance was set at p<0.05. Results. Since Jan 2002, an Taiwan AS database with 2647 samples from AS patients, including 982 first-visit patients, 130 Peripheral mononuclear cell samples with RNA and 932 DNA samples were collected. The reliability of three Bath instruments—the BASDAI, BASFI, and BAS-G—for a 24-hours test-retest showed acceptable intraclass correlation coefficients (0.92-0.94). Our Chinese versions of the BASDAI, BASFI, and BAS-G also showed 0.87, 0.94, and 0.90, respectively, with Cronbach’s alpha coefficient, indicating good reliability. In this AS database, mean age was 34.41 ± 11.23 and delay diagnosis time lag was 5.17 ± 7.39 years. Sex ratio (M:F) was around 3:1. Average BASDAI was 3.92 ± 2.23, BASFI 2.12 ± 2.19 and BAS-G 4.17 ± 2.81 cm in 10-cm scale. Less than 40% of AS patients were regularly treated. Peripheral arthritis was found in 65.75％ of patients, uveitis in 23.03％ and psoriasis in 14.82. 61.38% of AS patients are disease-active and 27.67% are functional disabled. Less than 40% of first visit AS patients were under regular treatment. Significant correlations were demonstrated between BASDAI and BASFI, BASDAI and BAS-G, and BASFI and BAS-G, respectively. When comparing the scores of BASDAI (4.1 v 3.9), BASFI (2.5 v 1.9), and BAS-G (4.5 v 3.9), higher scores of BASDAI, BASFI, and BAS-G were observed in the juvenile onset disease (JAS) group than in the adult onset disease (AAS) group. Major HLA-B27 subtype of AS patients in Taiwan was B2704 (89%) and B2705 (11%), different from B2705 in the Caucasians. For HLA-B27 negative AS, we found significant high ratio of HLA-B60 (68.3% vs 38.0%, OR=3.5, 95% CI 1.8 to 6.8, p<0.001) and B61 gene (OR 19.2 , 95% CI 9.5 to 38.9, p<0.001) ESR, CRP, HS-CRP and IgA all correlate well with BASDAI, BASFI and BAS-G index. MMP-3 is a potential useful biomarker to predict AS activity. Plasma Hcy level increased significantly in AS patients under sulfasalazine (10.4 ±3.8 mmol/L, p<0.05), MTX (11.9 ±4.7, p<0.05) and sulfasalazine/MTX combination treatment (11.2 ±2.6, p<0.05) when compared with normal controls (8.6 ±1.2 mmol/L) and AS patients without DMARD(9.4 ± 2.6 mmol/L). No correlation between disease activity and plasma Hcy level was found. Daily supplement of vitamin B-12 0.5 mg, B-6 50 mg and folic acid 5 mg can lower Hcy level in 2 weeks (32.3 ± 24.0 vs. 15.6 ± 11.1 mmol/L, p=0.007 ). Conclusions. Our Chinese versions of the BASDAI, BASFI, and BAS-G showed adequate reliability, validity, and responsiveness to clinical change. Among this 2592 AS patients’ database, male to female ratio was around 3:1.Average duration of delayed diagnosis was 5.17 years. Peripheral arthritis was found in 65.75％ of patients, uveitis in 23.03％ and psoriasis in 14.82. In this database, 61.38% of AS patients are disease-active and 27.67% are functional disabled. Less than 40% of first visit AS patients were under regular treatment. ESR, HS-CRP, IgA and MMP-3 were all useful biomarkers in AS. Plasma homocysteine level increased significantly in AS patients because of sulfasalazine and methotrexate treatment. Daily supplement of vitamin can lower homocysteine level in 2 weeks. We had established a comprehensive clinical and tissue database of AS in Taiwan. This database can be used for further researches, medical practice and education.

THU0669 The association between harris hip score and disease activity or hip mri features in ankylosing spondylitis

Objectives:Ankylosing spondylitis (AS), which is a chronic rheumatologic disorder, may be associated with erectile dysfunction (ED). This study aims to investigate the incidence of erectile dysfunction in patients with AS with a control group and to investigate the risk factors for ED.Methods:All demographic data were recorded. Participants in both groups filled in the IIEF-5 (International Index of Erectile Function), Beck Depression Index (BDI) and Beck Anxiety Index (BAI) questionnaires, whereas patients with AS additionally filled in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrological Index (BASMI) and Ankylosing Spondylitis Quality of Life (ASQoL) questionnaires. Patients were compared concerning erectile function and predictive factors. Fifty patients with the AS diagnosis and fifty healthy males were included in this study.Results:ED of all degrees was present in 38% and 30% of males in the AS group and control group, respectively, with no statistical difference. However, the mean IIEF-EF domain score of the AS group (22.3±7.0) was significantly lower than the control group (25.7±4.3) (p=0.004). In addition, BDI and BAI scores were significantly higher in the AS group. When we have divided patients in the AS group into two, according to the presence or absence of the ED, the mean IIEF-EF domain score of patients with ED was lower than AS patients without ED. No difference was detected in both groups concerning age and the duration of the disease. Patients who had ED in the AS group had significantly higher scores in BASDAI, BASFI, depression and anxiety; however, no significant difference was detected among groups regarding BASMI scores.Mean IIEF score was lower in patients with AS, and this had a negative correlation with BASDAI, BASFI, ASQoL, BDI and BAI scores.Conclusion:Erectile function scores were slightly lower in the AS group than the control group in our study. ED risk factors were shown as disease activity and psychological status.

Aim: The primary aim of the study was to compare the serum levels of Dickkopf-1 (DKK-1) and sclerostin in patients with ankylosing spondylitis (AS) and healthy controls. The secondary aim was to evaluate the effects of anti-tumor necrosis factor alpha (TNF-α) treatments on levels of DKK-1 and sclerostin. The last aim was to evaluate any relationship between DKK-1, sclerostin, and radiologic progression in AS. Material and Method: We included 70 patients with AS (35 anti-TNF-α treated, 35 anti-TNF-α naive) and 31 healthy controls in this study. Serum DKK-1, sclerostin, C reactive protein, and erythrocyte sedimentation rate (ESR) were assessed in patients and healthy controls. The Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Metrology Index (BASMI), and Bath Ankylosing Spondylitis Functional Index (BASFI) were calculated for the patients. Radiographs were scored according to the modified Stoke AS Spine Score (mSASSS) by an experienced radiologist who was blinded to the patients’ identity. Results: Patients with AS who were treated with anti-TNF-α agent had higher scores of BASMI and mSASSS compared with the anti-TNF-α naive patients. Serum levels of DKK-1 and sclerostin were significantly lower in patients with AS than in healthy controls. There was a negative correlation between DKK-1 levels with ASDAS and BASMI in patients with AS. There was no correlation between DKK-1 or sclerostin levels with mSASSS. There was a positive correlation between BASMI score with mSASSS in patients with AS. Conclusion: DKK-1 levels in patients with AS were negatively correlated with BASMI, on the other hand, BASMI had a strong positive correlation with mSASSS. Therefore, these findings suggest that lower DKK-1 levels in patients with AS may play a role in new bone formation.

BackgroundAxial spondyloarthritis (axSpA) is associated to a significant economic and social burden, due to the fact that it affects young individuals during their most productive years of life. Sexuality is...

Objectives: This study aims to investigate the association of serum fetuin-A levels with disease activation and clinical parameters in ankylosing spondylitis (AS) patients. Patients and methods: Forty-seven AS patients (30 males, 17 females; mean age 39.7±11.1 years; range 20 to 69 years) and 30 healthy controls (14 males, 16 females; mean age 42.0±11.5 years; range 19 to 63 years) were included in the study. Erythrocyte sedimentation rate, C-reactive protein, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Radiology Index, and Bath Ankylosing Spondylitis Metrology Index were used in the assessment of AS. Serum fetuin-A levels were measured using ELISA. Results: Mean serum fetuin-A values in AS patients (984±203 ng/mL) were significantly lower compared to controls (1156±218 ng/mL) (p=0.001). While a statistically significant negative correlation was detected in AS patients between fetuin-A values and C-reactive protein (p=0.009, r=-0.377), no significant correlation was detected between erythrocyte sedimentation rate, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index or Bath Ankylosing Spondylitis Radiology Index parameters and fetuin-A. Conclusion: Serum fetuin-A levels in AS patients were lower than the control group. However, further research is required to establish the role of serum fetuin-A levels as a surrogate marker of disease activity.

Ankylosing spondylitis patient responses to TNFi is gender-specific: 6 year data from the distiller biologic registry

The incidence of ankylosing spondylitis (AS) has recently increased with a substantial rise in the proportion of female patients, making this investigation relevant.Objective: to investigate the clinical and laboratory parameters of inflammatory activity and functional status in male and female patients with AS at different stages of the disease.Patients and methods. Examinations were performed in 119 patients (82 men and 37 women) (mean age, 36.4±0.9 years) with AS and 34 patients (24 men and 10 women) (mean age 27.0±1.6 years) with non-radiographic axial spondyloarthritis (nr-axSpA). The investigators used the 1984 modified New York criteria to confirm AS diagnosis and the 2009 ASAS classification criteria for axial spondyloarthritis. They also determined AS activity by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and functional status by the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Bath Ankylosing Spondylitis Metrology Index (BASMI). For the calculation of enthesites, the validated index Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) was used; pain intensity in the last week was estimated using a visual analogue scale (VAS). Laboratory examination included the determination of ESR and HLA-B27 antigen. All the patients underwent a plain film of the pelvic bones; and patients with nr-axSpA had magnetic resonance imaging for sacroiliitis.Results and discussion. In both groups, there was a male preponderance and axial lesions were more common (among the patients with AS, there were 68.9% of the men with sacroiliac joint lesions and 53.7% of those with spinal involvement; among the patients with nr-axSpA, there were 80.0 and 67.6 %, respectively; p&gt;0.05). The HLA-B27 antigen was detected in the majority of patients with AS (86.6% of men and 91.7% of women) and in those with nr-axSpA (91.6 and 80.0%, respectively). Uveitis was more common in women with AS (32.4%), less common in men with AS (17.1%); (p&lt;0.05) and nr-axSpA (8.3%); uveitis was not observed in women with nr-axSpA (p&lt;0.001). The pain according to VAS was more intense in women (48.1±3.4 mm; p&lt;0.01); in the nr-axSpA group, its values were comparable in men and women (p&gt;0.05). The BASDAI and BASFI scores were similar in women at all stages of the disease (p&gt;0.05). The men with nr-axSpA had the best functional status (p&lt;0.01) with the same BASDAI activity (p&gt;0.05) compared with those with AS. The BASMI in patients with AS regardless of gender was higher than in those with nr-axSpA (p&lt;0.01). High BASDAI activity was more frequently detected in women with AS and nr-axSpA than in men (64.9 and 60.0%, respectively; p&lt;0.01). Low activity was not observed in any woman with nr-axSpA. Enthesitis was more common in women in both AS and nr-axSpA (81.0 and 80.0%, respectively; p&lt;0.05).Conclusion. In women, AS and nr-ax-SpA are more severe, starting at their early stage, which is manifested by a higher activity, functional failure, and a higher frequency of extra-axial manifestations.