Abstract
BackgroundAccurate prevalence data are important when interpreting diagnostic tests and planning for the health needs of a population, yet no such data exist for axial spondyloarthritis (axSpA) in the UK. In this cross-sectional cohort study we aimed to estimate the prevalence of axSpA in a UK primary care population.MethodsA validated self-completed questionnaire was used to screen primary care patients with low back pain for inflammatory back pain (IBP). Patients with a verifiable pre-existing diagnosis of axSpA were included as positive cases. All other patients meeting the Assessment of SpondyloArthritis international Society (ASAS) IBP criteria were invited to undergo further assessment including MRI scanning, allowing classification according to the European Spondyloarthropathy Study Group (ESSG) and ASAS axSpA criteria, and the modified New York (mNY) criteria for ankylosing spondylitis (AS).ResultsOf 978 questionnaires sent to potential participants 505 were returned (response rate 51.6 %). Six subjects had a prior diagnosis of axSpA, 4 of whom met mNY criteria. Thirty eight of 75 subjects meeting ASAS IBP criteria attended review (mean age 53.5 years, 37 % male). The number of subjects satisfying classification criteria was 23 for ESSG, 3 for ASAS (2 clinical, 1 radiological) and 1 for mNY criteria. This equates to a prevalence of 5.3 % (95 % CI 4.0, 6.8) using ESSG, 1.3 % (95 % CI 0.8, 2.3) using ASAS, 0.66 % (95 % CI 0.28, 1.3) using mNY criteria in chronic back pain patients, and 1.2 % (95 % CI 0.9, 1.4) using ESSG, 0.3 % (95 % CI 0.13, 0.48) using ASAS, 0.15 % (95 % CI 0.02, 0.27) using mNY criteria in the general adult primary care population.ConclusionsThese are the first prevalence estimates for axSpA in the UK, and will be of importance in planning for the future healthcare needs of this population.Trial registrationCurrent Controlled Trials ISRCTN76873217
Highlights
Accurate prevalence data are important when interpreting diagnostic tests and planning for the health needs of a population, yet no such data exist for axial spondyloarthritis in the UK
Accurate estimates of disease prevalence are important when planning for future health needs, yet no contemporary data exist for axial spondyloarthritis or ankylosing spondylitis (AS) in the UK
Understanding of the spectrum of axial spondyloarthritis (axSpA)/AS has changed considerably in the past decade, with MRI changes encapsulated into the Assessment of Spondyloarthritis International Society (ASAS) classification criteria
Summary
Accurate prevalence data are important when interpreting diagnostic tests and planning for the health needs of a population, yet no such data exist for axial spondyloarthritis (axSpA) in the UK. In this cross-sectional cohort study we aimed to estimate the prevalence of axSpA in a UK primary care population. Accurate estimates of disease prevalence are important when planning for future health needs, yet no contemporary data exist for axial spondyloarthritis (axSpA) or ankylosing spondylitis (AS) in the UK. In this study we investigated the prevalence of axSpA in a UK primary care cohort by applying contemporary classification criteria and imaging modalities to patients with inflammatory back pain (IBP) - the earliest and commonest symptom of axSpA. In this study we investigated the prevalence of axSpA in a UK primary care cohort by applying contemporary classification criteria and imaging modalities to patients with inflammatory back pain (IBP) - the earliest and commonest symptom of axSpA. [5]
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