Comparison of ankylosing spondylitis and non-radiographic axial spondyloarthritis in a multi-ethnic Asian population of Singapore
Comparison of ankylosing spondylitis and non-radiographic axial spondyloarthritis in a multi-ethnic Asian population of Singapore
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DOI：
10.1111/1756-185x.13603
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发表时间：
2019-08-01
影响因子：
2.5
通讯作者：
Fong, Warren
中科院分区：
文献类型：
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作者：
Hong, Cassandra;Kwan, Yu Heng;Fong, Warren
目的比较新加坡多民族亚裔人群中强直性脊柱炎(AS)和非放射学轴性脊柱炎(nr-axSpA)患者的临床特征、疾病活动性、患者报告的转归和相关并发症。方法我们使用新加坡总医院脊柱性关节炎的精确医学资料，以改善预后和疾病缓解(PRESPOND)。所有患者均符合AS国际工作组轴性SpA分类标准(AxSpA)中的2009年评估标准。在这些患者中，所有AS患者都符合1984年修订的纽约标准。使用标准化问卷记录基线特征、药物、疾病活动性、患者报告的结果和炎症标志物。结果共纳入262例axSpA患者(82%为中国人，79%为男性)。确诊时的平均年龄(SD)为32.4(13.1)岁，AS和nr-axSpA患者的平均年龄相似。AS患者年龄较大(平均年龄42.7[13.5]vs 37.4[13.8]岁，P=0.02)，病程较长(平均病程10.9[8.7]vs 6.4[4.8]年，P<；0.01)，Bath强直性脊柱炎计量指数(BASMI)较高(平均Basmi 3.1[2.3]vs 1.5[1.5]，P<；与nr-axSpA相比，人类白细胞抗原(HLA)-B27阳性(82%比68%，P=0.03)、合并葡萄膜炎(33%比17%，P=0.03)和高血压(17%比0%，P<；0.01)。与AS患者比较，NR-axSpA患者BAS-G评分(BAS-G平均46.9[16.8]vs 38.6[20.6]，P<；0.01)、Bath强直性脊柱炎疾病活动指数(平均[SD]4.2[1.6]vs 3.5[1.9]，P=0.02)和AS生活质量评分(ASQOL 4.9[4.8]vs 3.5[4.1]，P=0.04)显著高于AS患者。患者总体评估、Bath强直性脊柱炎功能指数、疾病活动评分-C-反应蛋白(CRP)、健康评估问卷、简明36躯体成分问卷和精神成分问卷在基线时相似，所用药物、平均血沉和CRP也相似。结论在我们的亚洲多民族队列中，AS患者更有可能是HLA-B27阳性，有葡萄膜炎、高血压和脊柱活动度较差，而nr-axSpA患者往往经历较差的幸福感和生活质量。
Objectives To compare clinical characteristics, disease activity, patient-reported outcomes and associated comorbidities between patients with ankylosing spondylitis (AS) and non-radiographic axial spondyloarthitis (nr-axSpA) in a multi-ethnic Asian population of Singapore. Methods We used data from the PREcision medicine in SPONdyloarthritis for Better Outcomes and Disease Remission (PRESPOND) registry in Singapore General Hospital. All patients fulfilled 2009 Assessment in AS International Working Group classification criteria for axial SpA (axSpA). Of these, all AS patients fulfilled the 1984 modified New York criteria. Baseline characteristics, medications, disease activity, patient-reported outcomes and inflammatory markers were recorded using standardized questionnaires. Results Two hundred and sixty-two axSpA patients (82% Chinese, 79% male) were included. Mean age (SD) at diagnosis was 32.4 (13.1) years, which was similar between AS and nr-axSpA patients. AS patients were older (mean age 42.7 [13.5] vs 37.4 [13.8] years, P = 0.02), had longer disease duration (mean disease duration 10.9 [8.7] vs 6.4 [4.8] years, P < 0.01), higher Bath Ankylosing Spondylitis Metrology Index (BASMI) (mean BASMI 3.1 [2.3] vs 1.5 [1.5], P < 0.01), more frequently human leukocyte antigen (HLA)-B27 positive (82% vs 68%, P = 0.03), associated with uveitis (33% vs 17%, P = 0.03), and hypertensive (17% vs 0%, P < 0.01) compared to nr-axSpA, respectively. Nr-axSpA patients had higher Bath Ankylosing Spondylitis Global Score (BAS-G) (mean BAS-G 46.9 [16.8] vs 38.6 [20.6], P < 0.01), Bath Ankylosing Spondylitis Disease Activity Index (mean [SD] 4.2 [1.6] vs 3.5 [1.9], P = 0.02) and AS quality of life (ASQoL) (mean ASQoL 4.9 [4.8] vs 3.5 [4.1], P = 0.04) scores compared to AS patients respectively at baseline. Patient global assessment, Bath Ankylosing Spondylitis Functional Index, AS Disease Activity Score - C-reactive protein (CRP), Health Assessment Questionnaire, Short-Form 36 physical component summary and mental component summary were similar in both groups at baseline, as were medications used and mean erythrocyte sedimentation rate and CRP. Conclusions In our multi-ethnic Asian cohort, patients with AS are more likely to be HLA-B27 positive, have uveitis, hypertensive, and have poorer spinal mobility, while nr-axSpA patients tend to experience poorer well-being and quality of life.