Clinical characteristics of non-radiographic versus radiographic axial spondyloarthritis in Asia and non-radiographic axial spondyloarthritis in other regions: results of the cross-sectional ASAS-COMOSPA study.
Clinical characteristics of non-radiographic versus radiographic axial spondyloarthritis in Asia and non-radiographic axial spondyloarthritis in other regions: results of the cross-sectional ASAS-COMOSPA study.
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DOI：
10.1136/rmdopen-2021-001752
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发表时间：
2021-09
期刊：
影响因子：
6.2
通讯作者：
Kaname S
中科院分区：
文献类型：
--
作者：
Kishimoto M;Ono K;Fukui S;Kawaai S;Deshpande GA;Yoshida K;Ichikawa N;Kaneko Y;Kawasaki T;Matsui K;Morita M;Tada K;Takizawa N;Tamura N;Taniguchi A;Taniguchi Y;Tsuji S;Okada M;Kobayashi S;Komagata Y;López-Medina C;Molto A;van der Heijde D;Dougados M;Tomita T;Kaname S
描述亚洲与非亚洲地区非放射学中轴型脊柱关节炎（nr-axSpA）的特征，并比较亚洲地区放射学axSpA（r-axSpA）与nr-axSpA。数据来自国际脊柱关节炎评估协会-脊柱关节炎并发症数据库。按地区对患者进行分类，我们比较了来自亚洲与其他地区（欧洲、美洲和非洲）的nr-axSpA患者的临床特征。在亚洲人中，我们还比较了nr-axSpA与r-axSpA患者的特征。在3984例SpA病例中，1094例来自亚洲国家。在亚洲的780例axSpA患者中，112例（14.4%）患有nr-axSpA，低于非亚洲国家（486/1997，24.3%）。亚洲的Nr-axSpA患者主要为男性（75.9% vs 47.1%），发病时（22.8 vs 27.8岁）和诊断时（27.2 vs 34.5岁）较年轻，与非亚洲国家的Nr-axSpA相比，诊断延迟较少（1.9 vs 2.9年）。与非亚洲国家的nr-axSpA患者相比，亚洲的nr-axSpA患者表现出更高的人类白细胞抗原-B27患病率（90.6% vs 61.9%），更少的外周SpA特征（53.6% vs 66.3%）以及相似的关节外和共病率。亚洲nr-axSpA患者的疾病活动、功能损害和MRI骶髂关节炎较少，非甾体抗炎药反应率较高，甲氨蝶呤和生物疾病缓解抗风湿药使用较少。在亚洲，与nr-axSpA相比，r-axSpA表现出更高的疾病活动性和结构损伤，在其他特征上没有差异。在axSpA中，在亚洲观察到较低的nr-axSpA频率。我们的研究结果为更好地了解临床特征和优化诊断策略提供了机会，例如确保MRI资源的可访问性和可用性，以准确诊断亚洲的nr-axSpA。
To delineate characteristics of non-radiographic axial spondyloarthritis (nr-axSpA) in Asia versus non-Asian regions, and compare radiographic axSpA (r-axSpA) with nr-axSpA within Asia. Data were collected from the Assessment of SpondyloArthritis international Society-COMOrbidities in SPondyloArthritis database. Categorising patients by region, we compared clinical characteristics between nr-axSpA from Asia vs elsewhere (Europe, the Americas and Africa). Within Asians, we additionally compared patient characteristics of those with nr-axSpA versus r-axSpA. Among 3984 SpA cases, 1094 were from Asian countries. Of 780 axSpA patients in Asia, 112 (14.4%) had nr-axSpA, less than in non-Asian countries (486/1997, 24.3%). Nr-axSpA patients in Asia were predominantly male (75.9% vs 47.1%), younger at onset (22.8 vs 27.8 years) and diagnosis (27.2 vs 34.5 years), and experienced less diagnostic delay (1.9 vs 2.9 years) compared with nr-axSpA in non-Asian countries. Nr-axSpA in Asia exhibited higher human leucocyte antigens-B27 prevalence (90.6% vs 61.9%), fewer peripheral SpA features (53.6% vs 66.3%) and similar extra-articular and comorbid disease rates compared with those with nr-axSpA in non-Asian countries. Disease activity, functional impairment and MRI sacroiliitis were less in nr-axSpA in Asia, with higher rates of non-steroidal anti-inflammatory drug response and less methotrexate and biological disease-modifying antirheumatic drugs use. Within Asia, r-axSpA showed higher disease activity and structural damage compared with nr-axSpA, with no differences in other features. Among axSpA, lower frequency of nr-axSpA was observed in Asia. Our results offer an opportunity to better understand clinical characteristics and optimise diagnostic strategies, such as ensuring access and availability of MRI resources for accurate diagnosis of nr-axSpA in Asia.
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