BackgroundIt is known that genetic and environmental factors play a role in the pathogenesis of spondyloarthritis (SpA). [1] It can be thought that spouses living in the same house are exposed to similar environmental factors.ObjectivesThis study aimed to investigate whether common living space increases the frequency of SpA development in unrelated spouses of SpA patients.MethodsBetween November 2021 and June 2022, 680 SpA patients who applied to the Hacettepe University rheumatology outpatient clinic were included. Patients were divided into ankylosing spondylitis (AS), non-radiographic SpA, and peripheral SpA. The patients were asked whether their spouses had SpA, and if they had SpA diagnosis, they were called to the outpatient clinic, and their diagnosis was confirmed. The family history of the patients and their use of bDMARDs were also noted. It was also checked whether the patients whose spouses had SpA findings fulfilled the AS criteria.Results680 SpA patients were evaluated. There were 582(85.6%) AS, 72(10.6%) nr AxSpA, and 26 only peripheral SpA (3.8%). 49.4% of the patients were male, and the mean age was 45.6 (10.4). The mean follow-up period of the patients was 10.6 (7.9) years. Of all patients, 468 (55.1%) were using a bDMARD at the time of evaluation. 12 SpA patients stated that their spouses had SpA. In the review of these patients, it was found that four patients did not have SpA, and one of them had PsA. Spouses of patients with nr AxSpA and peripheral SpA did not have AS/SpA AS was detected in the spouses of 7 patients. The incidence of AS in the entire SpA patient group was calculated as 7/695 (1.01% (0.4-2.1)). The incidence of AS in spouses of AS patients are 7/582 (1.20% (0.5-2.5)) calculated. 2 of 7 wives were cousins’ children. The incidence of AS in unrelated spouses of AS patients are 5/580 (0.86% (0.3-2)). Only one of the spouses with AS knew her spouse’s diagnosis at the time of marriage, while the other six were diagnosed after marriage. The median time for these patients to be diagnosed after marriage is 22 (7-32) years.ConclusionIn the Turkish population, the frequency of AS was 0.49%, and the frequency of SpA was 1.05%. [2] The incidence of AS in the spouses of SpA patients has increased approximately two times compared to the average Turkish population. A 2.4-fold increased risk was found in AS patients. This situation may be related to environmental factors that play a role in the pathogenesis of SpA disease. However, the fact that half of the patients were using bDMARDs suggests that they were analyzed in the group with the potential for more severe disease. The results require confirmation in more extensive studies.References[1]Hwang, M.C., L. Ridley, and J.D. Reveille,Ankylosing spondylitis risk factors: a systematic literature review.Clinical Rheumatology, 2021.40(8): p. 3079-3093.[2]Onen, F., et al.,Prevalence of ankylosing spondylitis and related spondyloarthritides in an urban area of Izmir, Turkey.The Journal of rheumatology, 2008.35(2): p. 305-309.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
BackgroundIn axial spondyloarthritis (axSpA), intervertebral ossification bridges of consecutive vertebrae may progress to advanced spinal ankylosis and bamboo spine over the years [1].ObjectivesTo identify demographic, clinical, disease activity and treatment factors associated with development of bamboo spine / advanced spinal ankylosis and bamboo spine-only in the Hacettepe University Rheumatology Biologic Registry (HUR-BIO) cohort.MethodsHUR-BIO is a prospective, single center database of biological disease-modifying antirheumatic drug (bDMARD) treatments. 770 patients on bDMARDs treatment had both lumbar and cervical lateral radiographies at the time of the data collection, and were included in the study. Bamboo spine was defined Bath Ankylosing Spondylitis Radiologic Index (BASRI)-spine grade 4 with a complete fusion of lumbar and cervical spines. Advanced spinal ankylosis was defined as the presence of at least two intervertebral adjacent bridges and/or fusion at the lumbar and/or cervical spine without bamboo spine. We analyzed the ensemble of variables by multivariable logistic regression to identify predictors associated with bamboo spine / advanced spinal disease, and bamboo spine-only.ResultsIn the study, there were 99 patients with advanced spinal ankylosis and 78 patients with bamboo spine. Older age (OR 1.12, 95% CI 1.07-1.17), male gender (OR 4.26, 95% CI 1.75-10.41), delay diagnosis ≥ 24 months (OR 2.7, 95% CI 1.27-5.74), obesity (OR 4.03, 95% CI 1.53-10.64), hip involvement (OR 4.94, 95% CI 1.94-12.6), smoking ≥ 10 package/year (OR 2.28, 95% CI 1.003-5.2) were significantly associated factors with bamboo spine / advanced spinal ankylosis. Similarly, older age (OR 1.17, 95% CI 1.09-1.3), male gender (OR 8.31, 95% CI 2.09-33.1), obesity (OR 5.15, 95% CI 1.25-21.27), hip involvement (OR 4.74, 95% CI 1.32-16.96) and smoking ≥ 10 package/year (OR 3.19, 95% CI 1.03-9.89) were showed statistical significance with bamboo spine (Table 1).Table 1.Predictors of Bamboo Spine and Advanced Spinal Ankyloses, and Bamboo Spine-onlyMultivariable ModelCovariatesBamboo Spine and Advanced Spinal AnkylosisBamboo SpineOR (95% CI)p-valueOR (95% CI)p-valueAge1.12 (1.07-1.17)<0.001*1.17 (1.09-1.3)<0.001*Male (vs female)4.26 (1.75-10.41)0.001*8.31 (2.09-33.1)0.003*Delay Diagnosis (≥ 24 months vs <24 months)2.7 (1.27-5.74)0.01*2.39 (0.85-6.71)0.09BMI0.019*0.074- 25 to < 30 (vs <25)2.05 (0.77-5.46)0.153.37 (0.84-13.6)0.087- ≥ 30 (vs <25)4.03 (1.53-10.64)0.005*5.15 (1.25-21.27)0.024*Hip involvement (present vs absent)4.94 (1.94-12.6)0.001*4.74 (1.32-16.96)0.017Smoking (≥ 10 package/year vs <10 package/year)2.28 (1.003-5.2)0.049*3.19 (1.03-9.89)0.044*Family History of SpA (First-degree; present vs absent)1.67 (0.61-4.57)0.322.82 (0.79-10.06)0.11Uveitis History (present vs absent)1.04 (0.39-2.74)0.941.19 (0.33-4.29)0.79Use SSZ (present vs absent)0.6 (0.17-2.07)0.422.09 (0.39-11.28)0.39Use Corticosteroids (present vs absent)0.69 (0.27-1.75)0.430.73 (0.18-2.97)0.66*p <0.05BMI: Body mass index; SpA: Spondyloarthritis; SSZ: SulfasalazineConclusionData on the predictors of development of advanced spinal ankylosis and bamboo spine are scarce. In this study, we showed that older age, male gender, delay in diagnosis, obesity, hip involvement and smoking are factors that predict the development of advanced spinal involvement in axSpA.References[1]Ostergaard M, Lambert RG. Imaging in ankylosing spondylitis. Ther Adv Musculoskelet Dis. 2012;4(4):301-11.Disclosure of InterestsNone declared
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