An analysis of 372 patients with anterior uveitis in a large Ibero-American cohort of spondyloarthritis: the RESPONDIA Group.

OBJECTIVES: This study analysed the frequency of anterior uveitis (AU) and its correlations in a large cohort of patients with spondyloarthritis (SpA). METHODS: A common protocol of investigation was prospectively applied to 2012 SpA patients in 85 centres from 10 Ibero-American countries. Clinical and demographic variables and disease indexes were investigated. Categorical variables were compared by χ2 and Fisher's exact test, and continuous variables were compared by ANOVA or Kruskal-Wallis test. A value of p<0.05 was considered significant. RESULTS: AU was referred by 372 SpA patients (18.5%). AU was statistically associated with inflammatory low back pain (p<0.001), radiographic sacroiliitis (p<0.001), enthesopathies (p=0.004), urethritis/acute diarrhoea (p<0.001), balanitis (p=0.002), hip involvement (p=0.002), HLA-B27 (p=0.003), and higher C-reactive protein (p=0.001), whilst it was negatively associated with the number of painful (p=0.03) and swollen (p=0.005) peripheral joints, psoriatic arthritis (p<0.001), psoriasis (p<0.001), nail involvement (p<0.001), and dactilitis (p=0.062; trend). No association with gender, race, and indices (disease activity, functionality and quality of life) was observed. Logistic regression showed that ankylosing spondylitis (p=0.001) and HLA-B27 (p=0.083; trend) was significantly associated with AU, while extra-articular manifestations (predominantly psoriasis) were negatively associated (p=0.016). CONCLUSIONS: Anterior uveitis is a frequent extra-articular manifestation in SpA patients, positively associated with axial involvement and HLA-B27 and negatively associated with peripheral involvement and psoriatic arthritis.

Differential features between primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease.

OBJECTIVE: To describe differential characteristics of axial involvement in ankylosing spondylitis (AS) as compared with that seen in psoriatic arthritis (PsA) and inflammatory bowel disease (IBD) in a cohort of Ibero-American patients. METHODS: This study included 2044 consecutive patients with spondyloarthritis (SpA; ESSG criteria). Demographic, clinical, disease activity, functional ability, quality of life, work status, radiologic, and therapeutic data were evaluated and collected by RESPONDIA members from different Ibero-American countries between June and December 2006. Patients selected for analysis met modified New York criteria (mNY) for AS. RESULTS: A total of 1264 patients met the New York criteria for AS: 1072 had primary AS, 147 had psoriatic, and 45 had IBD-associated spondylitis. Median disease duration was comparable among the 3 patient groups. Patients with primary AS were significantly younger (p = 0.01) and presented a higher frequency of males (p = 0.01) than the other 2 groups. Axial manifestations such as inflammatory back pain and sacroiliac pain were significantly more frequent in patients with primary AS (p = 0.05) versus other groups, whereas frequency of dactylitis, enthesitis, and peripheral arthritis was more common in patients with psoriatic spondylitis (p = 0.05). Spinal mobility was significantly more limited in patients with primary AS versus the other 2 groups (p = 0.0001). Radiologic changes according to BASRI total score were equally significant in primary AS. Disease activity (BASDAI), functional ability (BASFI), and quality of life (ASQoL) scores were comparable in the 3 groups. CONCLUSION: Patients with primary AS had more severe axial involvement than those with spondylitis associated with psoriasis or IBD. Functional capacity, disease activity, and quality of life were comparable among the groups studied.

Registro Iberoamericano de Espondiloartritis (RESPONDIA): Perú / RESPONDIA. Iberoamerican Spondyloarthritis Registry: Perú

Antecedentes: La importancia del estudio de las espondiloartritis en el Perú data de 1980. Se desconocen la frecuencia y la incidencia de la enfermedad, así como la presencia del antígeno de histocompatibilidad HLA-B27. Un estudio de prevalencia de enfermedades reumáticas en el Perú asigna a las espondiloartritis el 0,4%. Hemos encontrado presencia del HLA-B27 en el 33% de los pacientes. Objetivos: Describir las características clínicas, sociodemográficas, radiológicas y genéticas de los pacientes con espondiloartritis atendidos en el servicio de reumatología del Hospital Nacional Edgardo Rebagliati de Lima (Perú). Métodos: Análisis descriptivo y transversal de la información recogida acerca de pacientes peruanos con espondiloartritis entre enero de 2007 y diciembre de 2008, y almacenada en línea en la página electrónica del grupo REGISPONSER (Registro de Espondiloartritis de la Sociedad Española de Reumatología). Se utilizó el programa SPSS versión 13.0. Resultados: Se incluyó a 60 pacientes (39 varones [65%]) de 40 años de edad media. El diagnóstico establecido con más frecuencia fue espondilitis anquilosante y, en segundo lugar, espondiloartritis juvenil. El 31% tuvo reactividad al HLA-B27 y el 18,6% tenía historia familiar de espondiloartritis. Las extremidades inferiores se afectaron con más frecuencia, y la lumbalgia inflamatoria y el síndrome sacroilíaco fueron la afección axial más frecuente. Encontramos tarsitis en 31 pacientes (53,4%). El tratamiento más utilizado fue la sulfasalazina. Conclusión: Las características clínicas, demográficas y radiológicas de pacientes peruanos con espondiloartritis son similares a las encontradas en otros países iberoamericanos. La espondilitis anquilosante fue el diagnóstico más frecuente en varones y al 31% de los pacientes se les encontró HLA-B27 positivo (AU)

Background: The study of spondyloarthritis in Peru dates back to 1980. The frequency and occurrence of the illness is unknown, as is the presence of HLA-B27. A prevalence study of rheumatic diseases in Peru that looked for spondyloarthritis showed it to be 0,4%. HLAB27 was found in 33% of the patients. Objectives: To describe the clinical, socio-demographics, radiological and genetic characteristics of the patients with spondyloarthritis who are attended by the department of rheumatology at the Hospital Nacional E. Rebagliati in Lima-Perú. Methods: Descriptive analysis and transferring of the information gathered from Peruvian patients with spondyloarthritis between January 2007 and December 2008 stored in the electronic web page of REGISPONSER. SPSS version 13.0 was used for statistical analysis. Results: We included 60 patients (39 men [65%]) averaging 40 years of age. The diagnosis established with a higher frequency was ankylosing spondylitis and, in second place juvenile spondyloarthritis. Thirty one percent was related to HLA-B27 and 18.6% had a familiar history of spondyloarthritis. The lower extremities were affected with a higher frequency and inflammatory_back pain and sacroiliac syndrome were the most frequent axial manifestation. We encountered tarsitis in 31 patients (53.4%). The most utilized treatment was sulfasalazine. Conclusion: The clinical, demographics and radiological characteristics of Peruvian patients with spondyloarthritis are similar to those from other Latin-American countries. Ankylosing spondylitis is diagnosed most frequently in men and 31% are HLA-B27 positive (AU)