Prevalence Of Spondyloarthropathy Research Articles

Clinical patterns of seronegative spondyloarthropathies in a tertiary centre in Pakistan.

ObjectivesThe patterns of spondyloarthropathies (SpA) differ across regions globally, and an understanding of these patterns is important for the correct diagnosis of this condition. The aim of this study was to evaluate the presenting symptoms and clinical patterns of SpA in a community of low socioeconomic status in Pakistan.MethodsThis clinical observational study was conducted in a tertiary care teaching hospital from July 2016 to June 2017. Five thousand patients were initially recruited in the rheumatology clinic. A total of 114 patients were finally selected and enrolled in this study, as defined by the inclusion criteria. All demographic variables were recorded and baseline clinical investigations were performed. The European Spondyloarthropathy Study Group (ESSG) diagnostic criteria were used to diagnose the condition and classify the study participants.ResultsOf the 114 patients, 64% (73 patients) were men and 36% (41 patients) were women. The mean age of the patients ranged 25–65 years. The men were affected twice as much as women with a ratio of 2:1.4. Men in the age group of 30–60 years constituted a large proportion of the study population. The most frequently diagnosed subtypes were ankylosing spondylitis, reactive arthritis, and psoriatic arthritis. The most common presenting symptoms were sacroiliitis, inflammatory spinal pain, and synovitis.ConclusionMales had a higher prevalence of SpA. Ankylosing spondylitis, psoriatic arthritis, and reactive arthritis were the most commonly diagnosed subtypes.

The prevalence of spondyloarthropathy in fibromyalgia patients

Objective: To document the prevalence of Spondyloarthropathy (SpA) with an evaluation of patients previously diagnosed with fibromyalgia syndrome (FMS).Methods: The patients diagnosed with FMS before telephoned and asked three questions to determine for inflammatory back pain. American College of Rheumatology (ACR) Fibromyalgia criteria 1990 and ACR 2010 and for diagnosing patients with SpA; criteria from the European Spondyloarthropathy Study Group (ESSG), and Amor were applied.Results: FMS was diagnosed according to 1990 ACR criteria in 14 (60.8%) SpA patients who were diagnosed with SpA according to the Amor criteria alone and in 10 (43.4%) patients who were diagnosed according to ESSG criteria alone, while it was diagnosed in 9 (33.3%) patients who were diagnosed with SpA according to Amor and ESSG criteria together and in 15 (65.2%) patients diagnosed with SpA according to Amor and/or ESSG criteria. The most tenderness was experienced in the bilateral shoulder supraspinatus tendon insertion region (57.7%) and in the sacroiliac joint (40.8%). Fourteen (60.8%) patients diagnosed according to ACR 1990 and 17 (51.6%) patients diagnosed according to ACR 2010 had plantar fasciitis and/or Achilles enthesopathy on foot radiography.Conclusions: There is a meaningful section of patients who are SpA or FMS and SpA are together in the patients thought to be FMS or the patients diagnosed with FMS according to ACR’s criteria can be said.

High Prevalence of Back Pain and Axial Spondyloarthropathy in Patients with Hidradenitis Suppurativa

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disease, causing fistulating sinuses in the intertriginous skin of axillary, genitofemoral and perianal sites. Objective: As other chronic inflammatory diseases, e.g. psoriasis, are frequently associated with spondyloarthropathies (SpA), the goal of this study was to quantify the prevalence of back pain and SpA in HS patients. Methods: A prospective questionnaire survey in 100 HS patients and a retrospective evaluation of pelvic magnetic resonance imaging (MRI) scans in 46 HS patients were conducted. Results: 71% of HS patients were suffering from back pain. There was no difference between age at onset of HS, disease duration, body mass index (BMI), or disease severity between HS patients with and without back pain. Evaluating pelvic MRI scans, 32.6% of HS patients showed signs of chronic SpA and 39.1% signs of active SpA. Again, no significant differences between patients with/without SpA were found regarding age at time of MRI, age at onset of HS, disease duration, smoking habits, and BMI. Furthermore, there was no correlation between these parameters and the degree of SpA. Limitations: Only patients with moderate/severe HS (Hurley stage II and III) in genitofemoral/perianal sites were analysed via MRI scans. Conclusion: Back pain and SpA are very common among patients with moderate/severe HS. Neither medical history nor clinical parameters provide hints for the presence of SpA.

Intestinal Flora Modification of Arthritis Pattern in Spondyloarthropathy.

The reactive form of spondyloarthropathy appears inducible by exposure to agents of infectious diarrhea, but do those organisms represent the tip of the iceberg, as indicated by renewed interest in gastrointestinal flora? Prevalence of spondyloarthropathy (20% of chimpanzees [Pan] and 28% of gorillas) is independent of subspecies and species, respectively. However, there are major differences in arthritis patterns, a characteristic shared with humans. Do patterns of arthritis correlate with gastrointestinal flora? Could such associated modifications be in the form of disease induction or represent protective effectors (at least against the extent of peripheral arthritis)? The skeletons of 2 chimpanzee subspecies (79 Pan troglodytes troglodytes and 26 Pan troglodytes schweinfurthii) and 2 gorilla species (99 Gorilla gorilla and 38 Gorilla beringei) adults were examined, and arthritis pattern noted. Feces of Eastern (P. schweinfurthii and G. beringei) and Western (great apes collected in their normal ranges) apes were assessed for 16S rRNA c and its character. Patterns of arthritis recognized on examination of skeletons showed geographic variation in skeletal distribution. East African apes (P. troglodytes schweinfurthii and G. beringei) had pauciarticular arthritis and frequent sacroiliac disease, whereas West African apes (P. troglodytes troglodytes and G. gorilla) had polyarticular peripheral joint disease with minimal sacroiliac involvement. DNA evidence revealed that Corynebactericeae were prominently represented in great apes with polyarticular disease, whereas Dietzia and Bifidobacterium exposure correlated with reduced peripheral joint arthritis distribution. Suggestions of a protective effect (in this case, limiting extent of peripheral arthritis, but not the disease itself) offered by these organisms are well represented by documented effects in other diseases (eg, tuberculosis) in the zoologic record. Perhaps it is this disease-modifying character that reduces the extent of the peripheral erosive disease, while increasing propensity to axial (sacroiliac) disease. A potential role for probiotic organisms in management of arthritis in humans is suggested, as has been documented for tuberculosis, gastrointestinal disorders, and food allergies.

FRI0214 Eular Project: Spondyloarthritis Prevalence in Serbia

BackgroundThere is a need to enable comparable spondyloarthropathy (SpA) prevalence estimates in Europe, which was made possible by the unique European EULAR project methodologyObjectivesto estimate the SpA prevalence in Serbia,...

FRI0276 Incidence of spondyloarthropathy in patients with inflammatory bowel disease: A population-based study

BackgroundSpondyloarthropathy (SpA) is an important extraintestinal manifestation of inflammatory bowel disease (IBD). The spectrum and incidence of this form of arthritis are not well studied in a defined population base.ObjectivesWe...

Epidemiology of Spondyloarthropathies in Central America

The authors reviewed retrospectively a cohort of 233 spondyloarthropathy patients observed in 2 centers in Guatemala City, Guatemala, and in hospitals in San Salvador, El Salvador, and San Jose, Costa Rica. Guatemalan patients were either from the clinic of Guatemalan Association against Rheumatic Diseases (n = 105) or from the private clinic of AGK (n = 78). El Salvador patients (n = 17) were from Hospital Instituto Salvadoreño del Seguro Social, and Costa Rican patients (n = 33) were from Hospital Calderon Guardia, San Jose, Costa Rica. Except for the Costa Rican data, which were published in 2007, the patients’ medical records were analyzed using standardized questionnaires. Prevalence of spondyloarthropathy was slightly higher in females than males (57% versus 43%, respectively). The median age was 47.5 years. Most of our patients were diagnosed with reactive arthritis or undifferentiated arthritis (47% and 33%, respectively); 10% of patients had ankylosing spondylitis and 9% psoriatic arthritis.

Human leukocyte antigen-B*2705 is the predominant subtype in the Korean population with ankylosing spondylitis, unlike in other Asians

This study was performed to investigate the frequency of human leukocyte antigen (HLA)-B27 subtypes in the Korean population with spondyloarthropathy (SpA). We determined the HLA subtypes of 267 SpA patients who were positive for the B27 antigen (as determined by serology) by using a PEL-FREEZ kit (Dynal Biotech, Wisconsin, USA). Clinical features, including sex, peripheral joint involvement, and the presence of uveitis, were analyzed in a retrospective cohort study. Among 267 patients, 244 were B*2705-positive and 22 were B*2704-positive. One patient was positive for B*2704/2705. No other subtype was observed among the analyzed patients. We found that HLA-B*2705 was the predominant subtype in Koreans with SpA; this finding is remarkable because other Asians such as the Han or the Japanese exclusively have the B*2704 subtype. This result suggests that the clinical features and prevalence of SpA in Koreans may be similar to those observed in Europeans.

Management of Spondyloarthropathy in Asian Countries

Spondyloarthropathy (SpA) comprises a family of chronic inflammatory arthritis disorders, and ankylosing spondylitis (AS) is regarded as the most frequent and severe subtype of SpA. The prevalence of SpA in Chinese is about 0.2-0.3%. Information about the management of SpA is limited in Asian countries. Non-steroidal anti-inflammatory drugs (NSAIDs) are still the medication of choice for relieving the spinal pain and morning stiffness of SpA. Traditional NSAIDs are relatively cheap and more readily available than selective COX-2 inhibitors in Asian countries. Diseasemodifying agents widely used in SpA include sulfasalazine (SSZ), thalidomide, methotrexate (MTX) and leflunomide. SSZ and MTX are the most frequently used in patients with SpA, even though there are few clinical trials to verify their efficacy. Thalidomide is potentially useful in treating severe and refractory AS patients. Tumor necrosis factor (TNF) inhibitors have been shown to be effective in the treatment of AS, but more attention needs to be given to potential tuberculosis (TB) infection. Traditional herbal medicine and acupuncture are also used in relieving pain and improving function in SpA patients in some Asian countries. This review will discuss the current therapeutic strategies for SpA. Keywords: Management, spondyloarthropathy, ankylosing spondylitis, Asia

Prevalence survey of rheumatoid arthritis and spondyloarthropathy in Lithuania

Objective: To assess the prevalence of rheumatoid arthritis (RA) and spondyloarthropathy (SpA) in two Lithuanian cities, Vilnius and Kaunas.Methods: The first step in this study involved the translation and validation of a telephone questionnaire developed by rheumatologists and epidemiologists in France. The second step comprised the prevalence survey. To detect RA and SpA cases in the populations of Vilnius and Kaunas, 6542 subjects selected randomly (every 50th) from the latest telephone book were interviewed by telephone using a validated case detection questionnaire (the screening phase). All subjects with rheumatic symptoms but an uncertain diagnosis were contacted by a rheumatologist (confirmation phase) by telephone. If the diagnosis remained uncertain, the subjects were invited for a rheumatological examination.Results: We attempted to contact 3370 telephone numbers in Vilnius and 3172 in Kaunas, and had a response rate of 62.5% and 67.7%, respectively. Over the course of all the study phases (telephone interview, rheumatologist's interview, and clinical examination), 39 RA cases and 27 SpA cases were detected, resulting in a crude prevalence of 0.92% for RA (95% CI 0.65–1.25) and 0.64% (95% CI 0.42–0.92) for SpA. The standardized prevalence rate according to age and sex in the Lithuanian population showed an RA prevalence of 0.55 (95% CI 0.39–0.74) and a SpA prevalence of 0.84 (95% CI 0.53–1.21).Conclusions: The prevalence of RA and SpA in Lithuania was found to be one of the higher rates in Europe. A telephone interview using a validated short questionnaire enabled a cost‐ and time‐saving epidemiological survey to be conducted to detect RA and SpA cases in the community.

Prevalence of spondyloarthropathies in an Italian population sample: a regional community‐based study

Objective. To estimate the prevalence of spondyloarthropathies (SpA) in an adult population in Marche, a region located in central Italy.Methods. A cross‐sectional population‐based study was conducted on a target adult population of 20 882. Questionnaires were sent to a random sample of 3664 individuals aged 18 years and over, selected from the lists of 16 general practices. Trained rheumatologists carried out structured visits in which respondent subjects were asked about symptoms of back pain, peripheral arthritis, joint swelling, psoriasis, and the occurrence of diarrhoea and dysuria. A family history of rheumatic disease, psoriasis, or uveitis was assessed. Cases were further classified as ankylosing spondylitis (AS), psoriatic arthritis (PsA), reactive arthritis (ReA), inflammatory bowel disease (IBD)‐associated arthritis, and undifferentiated SpA by the European Spondyloarthropathy Study Group (ESSG) criteria.Results. A total of 2155 subjects participated to the study (response rate 58.8%). Twenty‐three cases of SpA (18 men, five women, mean age 48.3 ± 12.1 years) were confirmed, with an overall prevalence of 1.06% [95% confidence interval (CI) 0.78–1.38]. The most common SpA was PsA, with a prevalence of 0.42% (95% CI 0.31–0.61), followed by AS with 0.37% (95% CI 0.23–0.49). Two cases with undifferentiated SpA, two with ReA, and two with IBD‐associated arthritis were also observed (0.09%, 95% CI 0.04–0.16).Conclusions. This is the first population‐based study that provides an estimate of the prevalence of SpA in Italy. PsA and AS were the most common SpA subsets. Further epidemiological studies are needed to obtain reliable prevalence rates and to better understand our findings.

The prevalence of extraintestinal manifestations and HLA association in patients with inflammatory bowel disease

To determine the prevalence, clinical and radiological characteristics of spondyloarthropathy (SpA) in patients with inflammatory bowel disease (IBD), to assess the association between HLA B27 and B51 and the extraintestinal symptoms and to evaluate whether IBD is associated with Behçet's disease (BD). One hundred and sixty-two consecutive adult patients with established diagnosis of IBD as either Crohn's disease (CD) or ulcerative colitis (UC) were evaluated. All the patients including those previously diagnosed with or without SpA had a complete rheumatologic examination and they were evaluated according to the European Spondyloarthropathy Study Group (ESSG) criteria for SpA and The International Study Group for Behçet's disease criteria for BD. The demographic and clinical data were recorded on a standardized form. The radiographies were obtained in all the patients and computed tomography (CT) was performed in the patients with suspected pelvic radiographies and/or low back pain in the physical examination. Radiological evaluation was made according to the Modified New York criteria. HLA B27, B51 and anti-neutrophile cytoplasmic antigen (ANCA) were searched in all the patients. Of the 162 patients with IBD (mean age 41.48+/-11.63 years, male 60, female 102), 78 were CD and 84 were UC. The mean of the IBD duration was 54.92+/-50.32 months and SpA duration was 20.63+/-34.37 months. The prevalence of SpA and AS in IBD was 45.7 and 9.9%, respectively. Frequencies of SpA and AS, the difference between UC and CD were not significant. Spondylitis, enthesitis, peripheral arthritis, oral ulcer and uveitis were not different between UC and CD, but erythema nodosum was found significantly more common in the CD patients compared with UC patients (P=0.005). The duration of IBD and SpA was similar in both groups. As the IBD duration increased, the prevalence of SpA development decreased (rr=0.991, P=0.009). Of the IBD patients, 13.6% were asymptomatic for musculoskeletal manifestations of SpA and their sacroiliac radiographies and CTs showed grade 2 sacroiliitis. HLA B27, B51 and ANCA positivities were not different between the patients with UC and CD. HLA B27 was significantly more common in the patients with sacroiliitis, spondylitis, enthesitis, peripheral arthritis, erythema nodosum, uveitis (P<0.001) and oral ulcer (P=0.025). BD was diagnosed in none of the patients. ANCA positivity was found to be related with the presence of erythema nodosum and uveitis (P=0.001 and P=0.005). The prevalence of SpA and AS is higher in the prospectively evaluated patients with radiological studies than those in the previously published studies. There is a high prevalence of asymptomatic sacroiliitis in IBD. An early diagnosis of inflammatory arthritis in IBD patients may prevent a disability due to SpA and AS.

An Assessment of Back Pain and the Prevalence of Sacroiliitis in Sarcoidosis

Sarcoidosis is a chronic granulomatous multisystem disease in which arthritis is relatively common. Arthritis of the sacroiliac joints (sacroiliitis) has been described in sarcoidosis but is thought to be rare. The objective of this study was to determine the prevalence of sacroiliitis in a secondary-care population of patients with sarcoidosis. Patients attending a specialist secondary-care sarcoidosis clinic underwent evaluation of spinal symptoms using a standard back pain questionnaire, examination of spinal mobility, and laboratory measurements of erythrocyte sedimentation rate, C-reactive protein, serum angiotensin-converting enzyme, and neopterin/creatinine ratio. Tissue typing for the presence of the human leukocyte antigen (HLA)-B27 allele was undertaken. Radiographs of the sacroiliac joints were obtained in each patient and reviewed independently by two observers; a further observer reviewed disputed radiographs. Sixty-one patients completed the assessments (80.3% of all patients invited to participate). Forty-nine of 61 patients (80.3%) reported having back pain at some point in their lives. Thirty-one of 61 patients (50.8%) had a score on the back pain questionnaire suggestive of inflammatory spinal disease, but only 3 of these patients had erosive damage of the sacroiliac joints on radiography indicating sacroiliitis. One further patient had erosive damage on radiography, making a total of four individuals with evidence of sacroiliitis, a prevalence of 6.6%. Four patients (one patient with sacroiliitis) were positive for HLA-B27. The back pain questionnaire had a sensitivity of 75% and a specificity of 51% for sacroiliitis in this population. The prevalence of spondyloarthropathy in the normal population has been estimated to be 1.9%. In the sarcoid population studied the prevalence was 6.6% suggesting a possible association between these two conditions. The standard back pain questionnaire for the identification of inflammatory spinal disease had a low sensitivity and specificity in this population.

Clinical features of spondyloarthropathy in Chinese and native Indonesians.

The prevalence of spondyloarthropathy (SpA) in Chinese Indonesians is much higher than in native Indonesians. This is due to HLA-B27 subtype differences. In the present study we re-examined the clinical features of SpA in Indonesians to see whether, besides the HLA-B27 subtype differences, other factors affect the frequency of SpA. Seventy two patients with SpA were re-examined. The patients came from two clinics for rheumatic diseases. The overall entry ratio of Chinese to native Indonesians was 1:2. Ankylosing spondylitis (AS) was more frequent among the Chinese (n = 32, 94% B27 positive) than among the native Indonesians (n = 5, 40% B27 positive). HLA-B27 subtyping was performed on 22 of the 37 HLA-B27-positive AS patients. Twenty Chinese were positive for B*2704 and two native Indonesians were B*2705 positive. The clinical features of AS and reactive arthritis (ReA) showed no differences between the two populations and were similar to the clinical descriptions in other parts of the world. In conclusion, it can be stated that in spite of HLA-B27 subtype differences the clinical features of SpA in Chinese and native Indonesians are fully comparable.