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Journal of Rheumatology, The Journal of Rheumatology, 12(40), p. 2038-2041

DOI: 10.3899/jrheum.130588

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Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Part of a Common Spectrum or Distinct Diseases?

Journal article published in 2013 by Dinny Wallis, Nigil Haroon ORCID, Renise Ayearst, Adele Carty, Robert D. Inman
Distributing this paper is prohibited by the publisher
Distributing this paper is prohibited by the publisher

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Abstract

Objective.To investigate the features of ankylosing spondylitis (AS) and nonradiographic axial spondyloarthritis (nr-axSpA) in a Canadian cohort of 639 patients with AS and 73 patients with nr-axSpA.Methods.Clinical and laboratory data were compared for patients with AS and nr-axSpA enrolled in a longitudinal SpA cohort.Results.The proportion of male patients was higher in AS than in nr-axSpA (76.2% vs 47.9%; p < 0.0001). There was no difference in the presence of HLA-B27 between AS (78.9%) and nr-axSpA (72.5%) patients, nor in age at the time of diagnosis, although AS patients were younger at the time of symptom onset (23.9 yrs vs 26.4 yrs; p = 0.03). Disease duration at the time of last clinic visit was longer for AS than for nr-axSpA patients (17.7 yrs vs 12.1 yrs; p = 0.0002). Acute-phase reactants were higher in AS than in nr-axSpA (C-reactive protein 11.4 vs 5.2, p < 0.0001; erythrocyte sedimentation rate 13.7 vs 9.9, p = 0.02). The Bath Ankylosing Spondylitis Metrology Index was higher in patients with AS (2.84 vs 1.35, p < 0.0001).Conclusion.Patients with nr-axSpA were more likely to be female and to have lower inflammatory markers than patients with AS. When restricted to female patients only, acute-phase reactants did not differ significantly between AS and nr-axSpA. The evidence provides indirect support for the concept that nr-axSpA may represent an early form of AS, but that also has features of a distinct disease entity with significant burden of symptoms.