scholarly journals Changes in ankylosing spondylitis incidence, prevalence and time to diagnosis over two decades

RMD Open ◽  
2021 ◽  
Vol 7 (3) ◽  
pp. e001888
Author(s):  
Samantha S R Crossfield ◽  
Helena Marzo-Ortega ◽  
Sarah R Kingsbury ◽  
Mar Pujades-Rodriguez ◽  
Philip G Conaghan
Keyword(s):  
Back Pain ◽  
Ankylosing Spondylitis ◽  
Median Time ◽  
Patient Survival ◽  
Practice Research ◽  
Inflammatory Back Pain ◽  
Clinical Practice Research Datalink ◽  
Time To Diagnosis ◽  
Over Time ◽  
Incidence Prevalence

ObjectivesTo assess changes in ankylosing spondylitis (AS) incidence, prevalence and time to diagnosis, between 1998 and 2017.MethodsUsing UK GP data from the Clinical Practice Research Datalink, we identified patients diagnosed with AS between 1998 and 2017. We estimated the annual AS incidence, prevalence and length of time from first recorded symptom of back pain to rheumatology referral and diagnosis.ResultsWe identified 12 333 patients with AS. The incidence declined from 0.72 (±0.14) per 10 000 patient-years in 1998 to 0.39 (±0.06) in 2007, with this decline significant only in men, then incidence rose to 0.57 (±0.11) in 2017. By contrast, prevalence increased between 1998 and 2017 (from 0.13%±0.006 to 0.18%±0.006), rising steeply among women (from 0.06%±0.05 to 0.10%±0.06) and patients aged ≥60 (from 0.14%±0.01 to 0.26%±0.01). The overall median time from first symptom to rheumatology referral was 4.87 years (IQR=1.42–10.23). The median time from first symptom to diagnosis rose between 1998 and 2017 (from 3.62 years (IQR=1.14–7.07) to 8.31 (IQR=3.77–15.89)) and was longer in women (6.71 (IQR=2.30–12.36)) than men (5.65 (IQR=1.66–11.20)).ConclusionAS incidence declined significantly between 1998 and 2007, with an increase between 2007 and 2017 that may be explained by an improvement in the recognition of AS or confidence in diagnosing AS over time, stemming from increased awareness of inflammatory back pain and the importance of early treatment. The rising AS prevalence may indicate improved patient survival. The persisting delay in rheumatology referral and diagnosis remains of concern, particularly in women.

scholarly journals Chronic back pain in first-degree relatives (FDRs) of patients with ankylosing spondylitis: predictive value of HLA-B27 and persistence of inflammatory back pain over time

RMD Open ◽  
2020 ◽  
Vol 6 (3) ◽  
pp. e001418
Author(s):  
Karim Doughem ◽  
Michael H Weisman ◽  
Michael M Ward ◽  
Lianne S Gensler ◽  
Mariko Ishimori ◽  
...  
Keyword(s):  
Back Pain ◽  
Ankylosing Spondylitis ◽  
High Risk ◽  
Predictive Value ◽  
Chronic Back Pain ◽  
Heel Pain ◽  
Inflammatory Back Pain ◽  
Hla B27 ◽  
First Degree Relatives ◽  
Over Time

Background/PurposeFirst-degree relatives (FDRs) of patients with ankylosing spondylitis (AS) may be at high risk of spondyloarthritis. We examined the frequency, characteristics of chronic back pain (CBP), associated features, persistence of symptoms, and HLA-B27 allele frequency in FDRs of AS patients, also comparing those FDRs with participants in NHANES 2009–2010 with CBP.Methods399 FDRs of AS probands were divided into: (1) No CBP (subjects >40 years old at study visit without CBP) (n=162); (2) NICBP (non-inflammatory CBP) (n=82), and (3) CIBP (inflammatory CBP) (n=155). White FDRs with CBP were compared with 772 participants in NHANES 2009–2010 with CBP. FDRs were invited to return for reassessment.ResultsFDRs with CIBP had earlier onset of CBP than those with NICBP (p<0.001) and had higher frequency of heel pain than those without CBP (p=0.002). HLA-B27 occurred in 57% of FDRs with CIBP vs 39.6% of those without CBP (p=0.005, OR=1.9). Of 23 patients with CIBP at baseline re-evaluated 67.04±31.02 months later, 16 (73%) still had CIBP, whereas 4 (31%) of 13 NICBP patients seen 61.23±31.84 months later remained symptomatic.ConclusionCIBP in FDRs of AS patients is HLA-B27-associated, has earlier onset and tends to persist compared to NICBP.

scholarly journals TYPE III CAWLEY ANDERSSON LESION IN A CASE OF ANKYLOSING SPONDYLITIS

2014 ◽  
Vol 04 (02) ◽  
pp. 136-139
Author(s):  
Deepak Hegde ◽  
Ballal Arjun ◽  
Vinay Kumar C. ◽  
H. Ravindranath Rai
Keyword(s):  
Back Pain ◽  
Ankylosing Spondylitis ◽  
Morning Stiffness ◽  
Posterior Spinal Fusion ◽  
Chronic Inflammatory Disease ◽  
Inflammatory Back Pain ◽  
Type Iii ◽  
Lesion Type ◽  
Andersson Lesion ◽  
Spinal Ligament

Abstract:Ankylosing spondylitis (AS) is a chronic inflammatory disease that affects especially males in the second and third decades of life.1 The main clinical symptom is inflammatory back pain typically occurring at night and morning stiffness improving after exercise.1 Apart from syndesmophytes and ankylosis of the spine resulting in rigidity, in longstanding ankylosing spondylitis, also focal destructive 1 discovertebral lesions (Andersson lesions) can occur.1 The case we present here is of a 35 year old male patient who presented to us with the symptoms of pain of upper back and both shoulders for 6 years. Pain was followed with stiffness of the neck and shoulder. Radiography of the dorsolumbar spine revealed squaring of the vertebra, syndesmophytes, calcification of the anterior spinal ligament, end plate irregularity at D10-D11 level, ill defined sclerosis with fracture of the ankylosed spine, features consistent with Andersson lesion type III. He underwent posterior spinal fusion with good functional outcome.

scholarly journals The incidence, prevalence, and survival of systemic sclerosis in the UK Clinical Practice Research Datalink

2018 ◽  
Vol 37 (8) ◽  
pp. 2103-2111 ◽  
Author(s):  
Jeremy G. Royle ◽  
Peter C. Lanyon ◽  
Matthew J. Grainge ◽  
Abhishek Abhishek ◽  
Fiona A. Pearce
Keyword(s):  
Clinical Practice ◽  
Systemic Sclerosis ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
The Uk ◽  
Incidence Prevalence

Ankylosing spondylitis, other spondyloarthritides, and related conditions

2010 ◽  
pp. 3603-3616 ◽  
Author(s):  
J. Braun ◽  
J. Sieper
Keyword(s):  
Rheumatoid Arthritis ◽  
Back Pain ◽  
Ankylosing Spondylitis ◽  
Gastrointestinal Tract ◽  
Rheumatic Diseases ◽  
Skin Lesions ◽  
Inflammatory Back Pain ◽  
Psoriatic Skin ◽  
Inflammatory Rheumatic Diseases ◽  
History Of

The spondyloarthritides are a group of inflammatory rheumatic diseases with predominant involvement of axial and peripheral joints and entheses, together with other characteristic clinical features, including inflammatory back pain, sacroiliitis, peripheral arthritis (mainly in the legs), enthesitis, dactylitis, preceding infection of the urogenital/gastrointestinal tract, psoriatic skin lesions, Crohn-like gut lesions, anterior uveitis, and a family history of Spondyloarthritis. They are the second most frequent inflammatory rheumatic diseases after rheumatoid arthritis....

The epidemiology of ankylosing spondylitis, axial spondyloarthritis, and back pain

2016 ◽  
Author(s):  
Stefan Siebert ◽  
Sengupta Raj ◽  
Alexander Tsoukas
Keyword(s):  
Back Pain ◽  
Ankylosing Spondylitis ◽  
Axial Spondyloarthritis ◽  
Epidemiological Studies ◽  
Population Based ◽  
Inflammatory Back Pain ◽  
True Incidence ◽  
Primary Care Population ◽  
Prevalence Estimates ◽  
History Of

Low back pain is a leading cause of disability worldwide. The prevalence of inflammatory back pain (IBP) has been calculated to be in the range 8–15% in a UK primary care population and 5–7% in a US population-based cohort. IBP rates are significantly higher in patients with psoriasis, uveitis, or inflammatory bowel disease than the general population. There is a paucity of good epidemiological studies to define the true incidence and prevalence of ankylosing spondylitis (AS), axial spondyloarthritis (axSpA), and spondyloarthritis (SpA), with wide variation as a result of geographic, demographic and methodological factors. The global prevalence estimates range from 0.01–0.2% for AS, to 0.32–0.7% for axSpA and around 1% for SpA overall. The global incidence estimates range from 0.44–7.3 cases per 100,000 person-years for AS to 0.48–62.5 cases per 100,000 person-years in SpA. The demographics and natural history of disease progression are also discussed.

scholarly journals Outputs and Growth of Primary Care Databases in the United Kingdom: Bibliometric Analysis

2017 ◽  
Vol 24 (3) ◽  
pp. 284 ◽  
Author(s):  
Zain Chaudhry ◽  
Fahmida Mannan ◽  
Angela Gibson-White ◽  
Usama Syed ◽  
Shirin Ahmed ◽  
...  
Keyword(s):  
United Kingdom ◽  
Web Of Science ◽  
Scientific Information ◽  
General Medicine ◽  
Practice Research ◽  
Health Improvement ◽  
Clinical Practice Research Datalink ◽  
Thomson Scientific ◽  
Health Database ◽  
Over Time

Background: Electronic health database (EHD) data is increasingly used by researchers. The major United Kingdom EHDs are the ‘Clinical Practice Research Datalink’ (CPRD), ‘The Health Improvement Network’ (THIN) and ‘QResearch’. Over time, outputs from these databases have increased, but have not been evaluated.Objective: This study compares research outputs from CPRD, THIN and QResearch assessing growth and publication outputs over a 10-year period (2004-2013). CPRD was also reviewed separately over 20 years as a case study.Methods:  Publications from CPRD and QResearch were extracted using the Science Citation Index (SCI) of the Thomson Scientific Institute for Scientific Information (Web of Science). THIN data was obtained from University College London and validated in Web of Science. All databases were analysed for growth in publications, the speciality areas and the journals in which their data have been published.Results: These databases collectively produced 1,296 publications over a ten-year period, with CPRD representing 63.6% (n=825 papers), THIN 30.4% (n=394) and QResearch 5.9% (n=77). Pharmacoepidemiology and General Medicine were the most common specialities featured. Over the 9-year period (2004-2013), publications for THIN and QResearch have slowly increased over time, whereas CPRD publications have increased substantially in last 4 years with almost 75% of CPRD publications published in the past 9 years.Conclusion: These databases are enhancing scientific research and are growing yearly, however display variability in their growth. They could become more powerful research tools if the National Health Service and general practitioners can provide accurate and comprehensive data for inclusion in these databases.

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