The disease burden of axial spondyloarthritis: through a gendered lens

Author(s):  
Sara Khan ◽  
Divya Shridharmurthy ◽  
Kate L. Lapane ◽  
Catherine Dube ◽  
Jonathan Kay ◽  
...  
2020 ◽  
Vol 16 (3) ◽  
pp. 240-244 ◽  
Author(s):  
Nessrine Akasbi ◽  
Siar Nihad ◽  
Zoukal Sofia ◽  
El Kohen Khadija ◽  
Harzy Taoufik

Background: According to the new classification criteria developed by The Assessment of SpondyloArthritis International Society, patients with axial spondyloarthritis (axSpA) can be classified in 2 subgroups: Patients with radiographic axial spondyloarthritis: ankylosing spondylitis patients (AS) and those with non-radiographic axial spondyloarthritis (nr-axSpA). Objective: The aim of the present study is to describe and discuss the differences and similarities between the two subgroups. Patients and Methods: A cross-sectional study was conducted in a single rheumatology hospital in Morocco. These included patients diagnosed as having axial spondyloarthritis according to ASAS criteria 2010, during a period of 6 years. The AS and the nr-axSpA subgroups were compared for the various axSpA-related variables. Results: Of the 277 patients with a diagnosis of axial SpA who were included in this study, 160 had AS and 117 had nr-axSpA. AS and nr-ax-SpA shared a similar age at diagnosis, similar prevalence of low back pain, lumbar stiffness, extra-articular manifestations, BASDAI and BASFI. In the multivariate analysis, AS patients were mainly male with cervical stiffness, enthesitis, coxitis and high level of ESR (erythrocyte sedimentation rate). The females generally had a family history of SpA and arthritis and were associated to the nr-axSpA form in the univariate analysis. Conclusion: This was the first study to characterise patients with AS and nr-axSpA in Morocco. Consistent with other studies published, this study showed that patients with nr-axSpA and patients with AS shared a comparable degree of disease burden.


2021 ◽  
pp. jrheum.210750
Author(s):  
Philip J. Mease ◽  
Robert R. McLean ◽  
Blessing Dube ◽  
Mei Liu ◽  
Sabrina Rebello ◽  
...  

We thank Dr. Maguire et al1 for their interest in and appreciation of our study from the Corrona Psoriatic Arthritis/ Spondyloarthritis Registry comparing patient characteristics and disease burden between men and women with axial spondyloarthritis (axSpA).2 Dr. Maguire and colleagues raised a number of interesting questions around the causal relationship between the higher prevalence of depression and decreased work productivity we observed in women in our study.


2021 ◽  
pp. jrheum.201549
Author(s):  
Philip J. Mease ◽  
Robert R. McLean ◽  
Blessing Dube ◽  
Mei Liu ◽  
Sabrina Rebello ◽  
...  

Objective To compare patient characteristics and disease burden between men and women with axial spondyloarthritis (axSpA) in the US-based Corrona Psoriatic Arthritis/Spondyloarthritis (PsA/SpA) Registry. Methods Patients aged ≥18 years with axSpA enrolled in the Corrona PsA/SpA Registry between March 2013 and November 2018 who were not concurrently diagnosed with PsA were included. Patient demographics, clinical characteristics, disease activity, patient-reported symptoms, work productivity, and treatment history at enrollment were compared between men and women using t tests or Wilcoxon rank-sum tests for continuous variables and χ2 or Fisher’s exact tests for categorical variables. Results Of 498 patients with axSpA and available sex information, 307 (61.6%) were men and 191 (38.4%) were women. Compared with men, women had higher disease activity as measured by Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, and physician global assessment, and had higher tender/swollen joint counts and enthesitis scores (all P≤0.01). Women also had worse patient-reported symptoms (pain, fatigue, HAQ-S, and EQ-VAS; all P<0.05), greater work and activity impairment, and were less likely to work full time than men. Prior csDMARD and prednisone use was more common in women than in men (both P<0.05). Additionally, women were more likely to have diagnoses of depression and fibromyalgia (both P<0.01). Conclusion In this US registry of patients with axSpA, women had higher overall disease burden and more peripheral manifestations than men. Improved awareness of sex differences in the presentation of axSpA may aid physicians in earlier identification and improved disease management.


2019 ◽  
Vol 79 (2) ◽  
pp. 209-216 ◽  
Author(s):  
Clementina López-Medina ◽  
Anna Molto ◽  
Pascal Claudepierre ◽  
Maxime Dougados

ObjectivesTo compare the clinical manifestations, disease activity and disease burden between patients with radiographic (r-axSpA) and non-radiographic axial spondyloarthritis (nr-axSpA) over a 5-year follow-up period in the Devenir des Spondylarthropathies Indifferénciées Récentes (DESIR) cohort.MethodsPatients from the DESIR cohort who had X-ray images of the sacroiliac joints available at baseline and did not leave the study during the 5-year follow-up period because of a diagnosis other than axSpA were included. A unilateral rating of ‘obvious sacroiliitis’ by the local reader was considered sufficient for classification as r-axSpA. The incidence of first episodes of peripheral and extra-rheumatic manifestations was compared between the two groups using the incidence rate ratio and Cox regressions adjusted for sex, age and tumour necrosis factor blocker (TNFb) intake. Mean values of patient-reported outcomes (PROs) and days of sick leave over 5 years of follow-up were compared using mixed models adjusted for sex, age, TNFb intake and baseline values.ResultsIn total, 669 patients were included, of whom 185 (27.7%) and 484 (72.3%) were classified as r-axSpA and nr-axSpA, respectively. At baseline, the r-axSpA patients showed a significantly higher prevalence of males. After adjusting for age, sex and TNFb intake, Cox regressions for peripheral and extra-rheumatic manifestations did not show any significant differences between groups. Mixed models also showed similar mean levels in PROs and days of sick leave between groups over time.ConclusionThe incidence of peripheral and extra-rheumatic manifestations as well as the disease burden over time remained similar between r-axSpA and nr-axSpA groups after adjusting for intermediate variables.Trial registration numberNCT01648907


PLoS ONE ◽  
2015 ◽  
Vol 10 (4) ◽  
pp. e0123582 ◽  
Author(s):  
Brigitte Michelsen ◽  
Ragnhild Fiane ◽  
Andreas P. Diamantopoulos ◽  
Dag Magnar Soldal ◽  
Inger Johanne W. Hansen ◽  
...  

2018 ◽  
Vol 22 (02) ◽  
pp. 197-206 ◽  
Author(s):  
Lennart Jans ◽  
Anne Jurik ◽  
Iwona Sudoł-Szopińska ◽  
Claudia Schueller-Weidekamm ◽  
Iris Eshed ◽  
...  

AbstractAnterior chest wall (ACW) inflammation is not an uncommon finding in patients with axial spondyloarthritis (ax-SpA) and reportedly occurs in 26% of these patients. Radiologists may only be familiar with spinal and peripheral joint imaging, possibly due to the inherent challenges of ACW imaging on some cross-sectional imaging modalities. Knowledge of relevant joint anatomy and the location of sites of inflammation allows the interpreting radiologist to better plan appropriate imaging tests and imaging planes. Accurate assessment of disease burden, sometimes in the absence of clinical findings, may alert the treating rheumatologist, allowing a better estimation of disease burden, increased accuracy of potential imaging scoring systems, and optimize assessment and response to treatment. This article reviews salient anatomy and various imaging modalities to optimize diagnosis, important differential diagnoses, and the interpretation of ACW imaging findings in ax-SpA.


2018 ◽  
Vol 24 (6) ◽  
pp. 324-327 ◽  
Author(s):  
Kevser Gok ◽  
Gizem Cengiz ◽  
Kemal Erol ◽  
Salih Ozgocmen

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