Performance of the classification criteria in patients with late-onset axial spondyloarthritis

Bendahan, Louise T.; Machado, Natália Pereira; Mendes, Jamille Godoy; Oliveira, Thauana Luiza de; Pinheiro, Marcelo M.

doi:10.1080/14397595.2017.1320819

Cited by 14 publications

(16 citation statements)

References 38 publications

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“…In fact, the criterion of onset before the age of 45 years is an important difference between the modified New York criteria for classification of AS [ 14 ] and the ASAS classification criteria and is even the main cause for discrepancy between the two criteria sets in classifying patients with radiographic axSpA (r-axSpA) [ 15 ]. Since the publication of the ASAS criteria for axSpA, some data have become available on the age at onset of axSpA patients in Brazil [ 3 , 16 ] and China [ 17 ], but the majority of the data originate from Western Europe.…”

Section: Introductionmentioning

confidence: 99%

Age at onset in axial spondyloarthritis around the world: data from the Assessment in SpondyloArthritis international Society Peripheral Involvement in Spondyloarthritis study

et al. 2021

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Objectives Age at onset is useful in identifying chronic back patients at an increased risk of axial spondyloarthritis (axSpA). Yet, the majority of data on which the age at onset <45 years criterion was based originates from Europe. Therefore, it is unknown if this criterion applies in other parts of the world. We aimed to assess age at onset of axSpA and its relationship with HLA-B27 and gender across the world. Methods Analyses were applied to patients from 24 countries across the world with an axSpA diagnosis and known age at onset of axial complaints. Cumulative probability plots were used to display the cumulative distribution of age at onset of axial symptoms. Linear regression models were built to assess the effect of HLA-B27 and gender on age at onset of axial symptoms. Results 92% of 2,579 axSpA patients had an age at onset of axial symptoms <45 years, with only small variations across the geographical regions (Asia [n = 574; 94%], Europe & North America [n = 988; 92%], Latin America [n = 246; 89%], and Middle East & North Africa [n = 771; 91%]). Age at onset of axial symptoms was consistently lower in HLA-B27 positive patients (median 25[19–32] vs 31[22–39]) and male patients (median 25[19–33] vs 28[21–37]), but in multivariable models an additional statistically significant effect of male gender independent of HLA-B27 was only found in Asia. Conclusion Around the world, the large majority of axSpA patients had an age at onset of axial disease <45, with HLA-B27 and male gender associated with earlier disease onset.

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Section: Introductionmentioning

confidence: 99%

Age at onset in axial spondyloarthritis around the world: data from the Assessment in SpondyloArthritis international Society Peripheral Involvement in Spondyloarthritis study

et al. 2021

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“…The incidence of LO axSpA of 6.3% in our axSpA cohort is lower than that found in 2 Turkish studies, 7.9% and 8.9%, 5,13 and in 1 Brazilian study, 9.7%. 3 Lower rates of 3.5% were reported in cohorts in Spain 6 and Taiwan. 4 Geographic variation should be considered when discussing these studies, given the known variation in HLA-B27 prevalence.…”

Section: Discussionmentioning

confidence: 96%

“…1 Axial spondyloarthropathy has long been described as presenting in the third decade of life, with the onset rarely occurring at older than 45 years. 2 Previous research [3][4][5][6][7] has shown there is a cohort of patients developing axSpA beyond this age. Publications have been limited to small numbers of axSpA patients as part of a larger SpA cohort or small numbers of participants in dedicated axSpA studies.…”

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confidence: 99%

The Same But Different? An Analysis of Late-Onset Axial Spondyloarthropathy

Maguire

O’Shea²

2020

J Clin Rheumatol

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“…Despite the ASAS criteria has had a good performance, as shown above, their efficacy in diagnosing different populations varies, particularly in individuals with chronic back pain and whose pretest probability of axial SpA is low. Considering patients with back pain started after 45 years old, the ASAS axial criteria had also the best performance to classify as late-onset axial SpA in the clinical practice [8]…”

Section: Clinical Questionsmentioning

confidence: 99%

“…In an open-label and uncontrolled study, an ultrasoundguided retro-calcaneal bursa injection of 20 mg of methylprednisolone in 18 patients with SpA (27 cases of symptomatic Achilles enthesitis treated) improved pain (visual analog scale (VAS): 7 [4][5][6][7][8][9][10] vs 3 [0-7]; p < 0.0001) and ultrasound parameters (reduced tendon thickness and vascularity, peritendinous edema and bursitis and power Doppler signal intensity) after 6 weeks, without any complication documented until the last evaluation of each patient in the study (3 to 12 months) [71] (2C). A systematic literature review (which included only 5 studies, with only one RCT) questions the long-term effects of infiltration of glucocorticoids on the Achilles tendinopathy in general (not only in patients with SpA) and highlights the risk of tendon injuries and rupture [72] (2A).…”

Section: (2b) Infiltration With Glucocorticoidsmentioning

confidence: 99%

The Brazilian Society of Rheumatology guidelines for axial spondyloarthritis – 2019

et al. 2020

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Spondyloarthritis is a group of chronic inflammatory systemic diseases characterized by axial and/or peripheral joints inflammation, as well as extra-articular manifestations. The classification axial spondyloarthritis is adopted when the spine and/or the sacroiliac joints are predominantly involved. This version of recommendations replaces the previous guidelines published in May 2013. A systematic literature review was performed, and two hundred thirty-seven studies were selected and used to formulate 29 recommendations answering 15 clinical questions, which were divided into four sections: diagnosis, non-pharmacological therapy, conventional drug therapy and biological therapy. For each recommendation the level of evidence supporting (highest available), the strength grade according to Oxford, and the degree of expert agreement (inter-rater reliability) is informed. These guidelines bring evidence-based information on clinical management of axial SpA patients, including, diagnosis, treatment, and prognosis. The purpose of these guidelines is to bring evidencebased information on clinical management of axial SpA patients, including, diagnosis, treatment and prognosis, for rheumatologists, general physicians, allied-specialists (dermatology, ophthalmology and gastroenterology), and other allied-professionals, such as physiotherapists. This version replaces the previous guidelines published on May 26, 2013 [3] and should be updated every 4 years. Methods A systematic literature review was performed, with external review of an specialized group of the Brazilian

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Performance of the classification criteria in patients with late-onset axial spondyloarthritis

Cited by 14 publications

References 38 publications

Age at onset in axial spondyloarthritis around the world: data from the Assessment in SpondyloArthritis international Society Peripheral Involvement in Spondyloarthritis study

Age at onset in axial spondyloarthritis around the world: data from the Assessment in SpondyloArthritis international Society Peripheral Involvement in Spondyloarthritis study

The Same But Different? An Analysis of Late-Onset Axial Spondyloarthropathy

The Brazilian Society of Rheumatology guidelines for axial spondyloarthritis – 2019

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