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.
Background: Axial spondyloarthritis (axSpA) is frequent a group of chronic inflammatory disorders that predominantly affects the axial skeleton. It seems to occur more often in males than in females. There are gender differences in clinical presentation of axSpA. Women tend to have milder disease and may therefore be underdiagnosed. Male axSpA patients are more likely to develop radiographic spinal damage. Materials and Methods: A cross sectional study was conducted, during the period between January 2012 and December 2017, in a single rheumatology department in Morocco. In total, our study included patients with axial spondyloarthritis fulfilling the Assessment of SpondyloArthritis international Society (ASAS) classification criteria 2010. The data was recorded and compared for both bivariate and multivariate analysis. Objective: The aim of our study is to demonstrate the particularities of female axial spondyloarthritis in comparison to the male form. Results: In total, 277 patients were included of which 147 were female and 130 were male. In fact, women were older (46 vs 35; p <0.001), had more arthritisis than enthesitis ( respectivally 63.3% vs 36.7% ; p = 0.01 et 59% vs 41%; p = 0.045). There were no significant differences in prevalence of extra-articular manifestations, disease activity (BASDAI) nor BASFI. Multivariate logistic regression analysis suggested that female sex was associated with a greater age at presentation, (IC: 1,053-1,103, OR=1,07, p<0,001), and arthritis (IC: 2,37-4,26, OR=2,3, p=0.004). Conclusion : Comparison between male and female patients suffering from axial spondyloarthritis found differences and similarities in the disease expression. This study showed that women had less severe forms of spondyloarthitis.
Introduction: Magnetic resonance imaging of sacroiliac joints (MRI SI) is the gold standard imaging tool for axial spondyloarthritis (ax SpA) diagnosis, when the pelvic radiograph is normal or non-conclusive. In fact, subchondral bone marrow edema (BME) is the primary MRI feature of early ax SpA. The associated factors with active sacroiliitis on MRI are still not properly elucidate. The main objective of this study is to identify the relationship between active sacroiliitis on MRI, biomarkers of inflammation and Disease Activity Scores.Materials and methods: Our work could be categorized as a cross sectional study that enrolls all patients with non-radiographic axial spondyloarthritis (nr axSpA), meeting each; the assessment of SpondyloArthritis international Society axSpA criteria (ASAS 2009), and who were admitted in our Rheumatology Department, in the university hospital Hassan II of Fez (Morocco), all along the period laying between January 2012 and March 2018. The relationship between MRI-SI, Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), C reactive protein and erythrocyte sedimentation rate was investigated. Results: 105 patients were involved in the study. The average age was [44years ± 13.5]. The Sex ratio was about [1.4]. 29 % of patients were smokers. 76% of cases had active sacroiliitis on MRI, while only 28% had inactive sacroiliitis. The average CRP serum level was roughly [23.5 ± 36mg / l]. On the other side, the ESR blood level was almost [25.9±24mm/h]. 94.2% of patients used non-steroidal antiinflammatory drugs (NSAIDs). The average ASDAS value was about [2.3 ± 1]. Whereas the BASDAI one was [4.2± 1], and the BASFI one was about [4± 1.5]. Actually, No significant relationship was found between active sacroiliitis and inflammation’s biomarkers. Indeed, men had 5.6 times more active sacroiliitis, of which smokers had even 3 times more the risk to develop active sacroiliitis, while treatment with NSAIDs was proved to be a protective factor. Conclusion: Biomarkers of inflammation cannot be used as a marker of objective inflammation of sacroiliac joints on MRI; hence, the necessity of MRI screening, and more additional studies with larger number of patients, should be conducted, to identify this association even better.
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