Clinical and Epidemiological Aspects of Ankylosing Spondylitis Patients in a Single Center in Baghdad
DOI:
https://doi.org/10.51173/jt.v4i1.439Keywords:
Ankylosing Spondylitis, Gender, HLA B27 Positivity, Uveitis, Disease ActivityAbstract
Ankylosing spondylitis is a chronic inflammatory disease with axial involvement but also may present as a peripheral arthritis and extraarticular manifestations.
Objective: To assess clinical aspects of ankylosing spondylitis patients and different associated demographic variables in Baghdad teaching hospital.
Patients and methods: A cross-sectional study was carried out in Baghdad teaching hospital which includes 402 patients (≥ 18 years old) with a clinical diagnosis of AS according to Assessment of Spondylo Arthritis International Society for AS were involved in this study from June/2019 to June/2021. Demographic data and disease characteristics, presence of extra-articular manifestations (past and present) and measurement of disease activity was done by BASDAI, erythrocyte sedimentation rate (mm/h) and C-reactive protein (mg/L). In addition, HLAB27 typing was reported. Results: The age of onset for males was 24.87±8.8 and for females25.97±8.6 years, HLA typing HLA-B27 were 49.55% and 35.38% in males and females respectively and the association was found to be statistically significant (P. value =0.031). While family history was reported at 25.82% and 34.33% in males and females correspondingly. 75.07% of males compared to 71.38% of females were treated with Anti TNF therapy. Females had later onset of disease than males with lower percentage of HLA B27 positivity. Recommendation: more comprehensive assessment with advanced diagnostic and treatment standards.
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References
Kaipiainen-Seppanen O, Aho K, Heliovaara M: Incidence and prevalence of ankylosing spondylitis in Finland. J Rheumatol 1997; 24:496-9.
Ranganathan, V., Gracey, E., Brown, M. A., Inman, R. D., & Haroon, N. Pathogenesis of ankylosing spondylitis—recent advances and future directions. Nature Reviews Rheumatology, 2017;13(6), 359.
Xi Y, Jiang T, Chaurasiya B, Zhou Y, Yu J, Wen J et al. Advances in nanomedicine for the treatment of ankylosing spondylitis. Int J Nanomedicine. 2019; 14: 8521–8542.
KHAN MA: Clinical features of ankylosing spondylitis. In: HOCHBERG M, SILMAN A, SMOLENJ, WEINBLATTM(Eds.) Rheumatol- ogy.London:Mosby:ADivisionofHarcourt Health Sciences Ltd.2003;1161-81.
DeanLE,JonesGT,MacDonaldAG,DownhamC,SturrockRD, MacfarlaneGJ Global prevalence of ankylosing spondylitis. Rheumatology (Oxford, England) 2014,53(4):650–657. doi:10.1093/ rheumatology/ket387
LeeW, ReveilleJD,DavisJCJr,LearchTJ,WardMM,Weisman MHAretheregenderdifferencesin severity of ankylosing spondylitis? Results from the PSOAS cohort. Ann Rheum Dis 2007;66(5):633–638.doi:10.1136/ard.2006.060293
Feldtkeller E, Bruckel J, Khan MA. Scientific contributions of ankylosing spondylitis patient advocacy groups. Curr. Opin. Rheumatol. 2000;12(4), 239–247.
Wright GC, Kaine J, Deodhar A. Understanding differences between men and women with axial spondyloarthritis. Seminars in Arthritis and Rheumatism 50 (2020) 687-694.
Rudwaleit M, van der Heijde D, Landewe R, Akkoc N, Brandt J, Chou CT et al. The Assessment of Spondylo Arthritis international Society classifi cation criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann Rheum Dis 2011; 70:25–31. doi:10.1136/ard.2010.133645
Landi M, Maldonado-Ficco H, Perez-Alamino R, Maldonado-Cocco JA, Citera G, Arturi P et al. Gender differences among patients with primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease in an Iberoamerican spondyloarthritis cohort. Medicine (2016) 95:51
Jong HD, Paramarta JE, Winter JJH, Baeten DLP, de Sande MGH. Differences between females and males in axial spondyloarthritis: datafrom a real-life cross-sectional cohort.Scand J Rheumatol 2020;49:28–32.
Lee W, Reveille JD, Davis JC Jr, et al. Are there gender differences in severity of ankylosing spondylitis? Results from the PSOAS cohort. Ann. Rheum. Dis. 66(5), 633–638 (2007).
Dean LE, Jones GT, MacDonald AG, Downham C, Sturrock RD, Macfarlane GJ. Global prevalence of ankylosing spondylitis. Rheumatology (Oxford) 2014; 53: 650-657
Feldtkeller E, BruckelJ, KhanMA. Scientific contributions of ankylosing spondylitis patient advocacy groups. CurrOpin Rheumatol 2000;12(4):239–247.
DincerU,Cakar E,KiralpMZ,DursunH.()Diagnosisdelayin patients with ankylosing spondylitis: possible reasons and proposals for new diagnostic criteria.Clin Rheumatol 2008; 27 (4):457–462. doi:10.1007/s10067-007-0727-6
FeldtkellerE,ErlendssonJ(2008) Definition of disease duration in ankylosing spondylitis. Rheumatol Int 28(7):693–696. doi:10.1007/s00296-007-0499-y.
Yang M, Xu M, Pan X, Hu Z, Li Q, Wei Y et al. Epidemiological comparison of clinical manifestations according to HLA-B*27 carrier status of Chinese ankylosing spondylitis patients. Tissue Antigens 2013; 82(5):338–343.
Aggarwal R, Malaviya AN Clinical characteristics of patients with ankylosing spondylitis in India. Clin Rheumatol 2009;28 (10):1199–1205.doi:10.1007/s10067-009-1227-7.
KimTJ,KimTHClinical spectrum of ankylosing spondylitisin Korea.Joint,Bone,Spine:revuedurhumatisme2010;77(3):235– 240.doi:10.1016/j.jbspin.2009.11.015.
de Jong HMY, Paramarta JE, de Winter JJH, Baeten DLP and van de Sande MGH. Differences between females and males in axial spondyloarthritis: data from a real-life cross sectional cohort. Scand J Rheumatol 2020;49:28–32.
PoddubnyyD,RudwaleitM,HaibelH,ListingJ,Marker-Hermann E, Zeidler H, Braun J, Sieper J (2011) Rates and predictors of radiographic sacroiliitis progression over 2 years in patients with axial spondyloarthritis.AnnRheumDis2011;70(8):1369–1374.doi:10.1136/ard.2010.145995.
Cansu DU, Calisir C, SavasYavasU, KasifogluT, Korkmaz C Predictors of radiographic severity and functional disability in Turkish patients with ankylosing spondylitis. Clin Rheumatol 2011;30(4):557–562. doi:10.1007/s10067-010-1665-2
Webers C, Essers I, Ramiro S, et al. Gender-attributable differences in outcome of ankylosing spondylitis: long-term results from the Outcome in Ankylosing Spondylitis International Study. Rheumatology (Oxford). 2016;55(3), 419–428.
Siemons L, ten Klooster PM, Vonkeman HE, van Riel PLCM, Glas CAW, and van de Laar MAFJ. How age and sex affect the erythrocyte sedimentation rate and C-reactive protein in early rheumatoid arthritis. BMC Musculoskelet Disord. 2014; 15: 368. doi: 10.1186/1471-2474-15-368.
Swinnen TW, Westhovens R, Dankaerts W, Stolwijk C, Landewe R, van der Heijde D et al. Widespread pain in axial spondyloarthritis: clinical importance and gender differences. Arthritis. Res. Ther. 2018;20(1), 156.
Akassou A and Bakri Y. Does HLA-B27 Status Influence Ankylosing Spondylitis Phenotype? Clin Med Insights Arthritis Musculoskelet Disord. 2018; 11: doi: 10.1177/1179544117751627.
FeldtkellerE,KhanMA,vanderHeijde D,vander Linden S, Braun J Age at disease onset and diagnosis delayin HLA-B27 negative vs. positive patients with ankylosing spondylitis. RheumatolInt2003; 23(2):61–66. doi:10.1007/s00296-002-0237-4
WildnerG, Diedrichs-Mohring M, Thurau SR Induction of arthritis and uveitis in Lewisrats by antigenic mimicry of peptides from HLA-B27 and cytokeratin. Eur J Immunol 2002;32 (1):299–306.
Montilla C, del Pino-Montes J, Collantes-Estevez E, Font P, zarco P, Mulero J et al. Clinical Features of Late-onset Ankylosing Spondylitis: Comparison with Early-onset Disease. The Journal of Rheumatology 2012; 39:5;1008-1012.
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