Interethnic Variations and Clinical Features of Spondyloarthropathies in a Middle Eastern Country.

Mohammed Kamil Quraishi,Humeira Badsha,Srilakshmi Hegde,Kong Kok Ooi,Muhammad Shahzeb,Bhavna Khan,Ayman Mofti

doi:10.2174/1874312901812010010

Abstract

Objectives:The study aimed to demonstrate the interethnic differences and clinical features of Spondyloarthropathy(SpA) patients in a diverse Middle Eastern Country.Methods:A retrospective review of medical records to collect the required data was conducted for SpA patients at two study institutions in the United Arab Emirates.Results:Of 141 SpA patients found, 88 AS(Ankylosing Spondylitis) patients and 53 ‘other SpA’ patients were identified. Males constituted 81% of AS and 55% of ‘other SpA’ patients. Patients with AS and ‘other SpA’ had a mean age of symptom onset of 28 and 34 years, respectively.49% and 40% of AS and ‘other SpA’ patients had a history of Anti-TNF therapy usage. Enthesitis and Uveitis were noted in 16% and 18% of AS patients whilst 53% and 11% in ‘other SpA’ patients, respectively.Caucasian, Indian Subcontinent and Arabs constituted 93% of our cohort. Mean age of onset of symptoms in the Indian Subcontinent ‘other SpA’ group was much greater than the other two ethnicities. Duration of symptoms to diagnosis was 3.5 and 4 years in AS and other SpA patients' respectively. HLA-B27 positivity was found in 53%, 80% and 93% of Arab, Indian Subcontinent and Caucasian AS patients, respectively, whilst seen in 50%, 25% and 33% of the same respective ethnicties in ‘other SpA’ patients.Conclusion:This study on 141 patients is the largest to analyse inter-ethnic variations in SpA patients in the region. Our cohort shows a short delay in diagnosis with a relatively higher Anti-TNF usage.

Highlights

Spondyloarthropathies (Spondyloarthritis)(SpA) are a collection of chronic inflammatory rheumatic conditions that share multiple clinical features including axial and/or peripheral arthritis, enthesitis, absence of the serum rheumatoid factor and presence of common extra articular manifestations [1]
Our cohort shows a short delay in diagnosis with a relatively higher Anti-TNF usage
Research in recent years has documented the clinical features of Ankylosing Spondylitis in the Middle East

Summary

Introduction

Spondyloarthropathies (Spondyloarthritis)(SpA) are a collection of chronic inflammatory rheumatic conditions that share multiple clinical features including axial and/or peripheral arthritis, enthesitis, absence of the serum rheumatoid factor and presence of common extra articular manifestations [1]. The spondyloarthropathy family comprises of Ankylosing Spondylitis(AS), psoriatic arthritis, reactive arthritis, inflammatory bowel disease associated SpA, juvenile SpA and undifferentiated SpA(uSpA) [2]. These diseases are strongly associated with the genes of the Major Histocompatibility Complex (MHC), in particular, the Human Leucocyte Antigen(HLA) B27 [3, 4]. There remains a lack of information on whether similar inter-ethnic SpA profiles exist amongst other Middle Eastern countries. With the exception of a small case series on AS patients in the UAE, there has been no other comparison of inter-ethnic profiles of any SpA subtype in the Middle East [8]

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