ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2470

Combined Axial and Peripheral Involvement Is Associated With Miscegenation In A Large and Heterogeneous Brazilian Cohort Of 1505 Patients With Spondyloarthritis

Percival D Sampaio-Barros1, Mittermayer Santiago2, Adriana B. Bortoluzzo2, Antonio Carlos Ximenes2, José Antonio Braga da Silva2, Manoel B Bértolo2, Sandra Lúcia Ribeiro2, Mauro Keisermann2, Rita Menin2, Thelma L. Skare2, Sueli Carneiro2, Valderilio F. Azevedo2, Walber P. Vieira2, Elisa Albuquerque2, Washington A. Bianchi2, Rubens Bonfiglioli2, Cristiano Campanholo2, Hellen M Carvalho2, Izaias P. Costa2, Angela Luzia B. P. Duarte2, Charles Kohem2, Nocy Leite2, Sonia Lima2, Eduardo S. Meirelles2, Ivânio A. Pereira2, Marcelo M. Pinheiro2, Elizandra Polito2, Gustavo G. Resende2, Francisco AC Rocha3, Maria de Fátima L. C. Sauma2, Valéria Valim2 and Celio R. Gonçalves2, 1Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, 2Brazilian Registry of Spondyloarthritis, São Paulo, Brazil, 3Rheumatology, Brazilian Registry of Spondyloarthritis, São Paulo, Brazil

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Spondylarthropathies and Psoriatic Arthritis: Clinical Aspects and Treatment III

Session Type: Abstract Submissions (ACR)

Background/Purpose: Spondyloarthritides (SpA) constitute a group of diseases that can present different patterns according to the genetic background. Brazilis a large country with a heterogeneous population, constituted by 48.7% of whites, 50.6% African-Brazilians (43.6% Mulatos, originated from the miscegenation of whites and blacks, and 7.0% blacks of pure origin), and 0.7% of Asian ancestry (predominantly Japanese) and Indians (National Census, 2010).  This ethnic distribution varies a lot among the different geographic regions in the country.  The objective of this study is to analyze disease patterns in a large cohort of patients with SpA, according to the five main geographic regions.

Methods: Brazilian multicentric cross-sectional study of 1505 SpA patients according to the European Spondyloarthropathy Study Group (ESSG), evaluated by a standardized protocol. There were 762 patients from the Southeast (68% whites and 20.1% African-Brazilians), 272 from the Midwest (49.4% whites and 43.7% African-Brazilians), 258 from the South (84% whites and 12% African-Brazilians), 126 from the North (66.7% whites, 16.7% African-Brazilians, and 16.6% mixed, including Indians), and 87 from the Northeast (32.1% whites and 56% African-Brazilians).

Results: Patients from the South region presented higher frequency of axial involvement (p < 0.001) and uveitis (p = 0.001), whereas patients from the more miscegenated regions (Northeast and North) presented higher frequencies of combined axial and peripheral involvement (p < 0.001), and higher mean values of erythrocyte sedimentation rate (ESR) (p < 0.001) and C-reactive protein (CRP) (p < 0.001). Patients from the Northeast region were characterized by a higher frequency of male patients (p = 0.002), hip involvement (p < 0.001) and work incapacity (p = 0.001), with higher scores of Maastricht Ankylosing Spondylitis Enthesitis Score (MASES; p < 0.001), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI; p < 0.001), Bath Ankylosing Spondylitis Functional Index (BASFI; p < 0.001), and Ankylosing Spondylitis Quality of Life (ASQoL; p < 0.001). 

Conclusion: The present study provides evidence that miscegenation in the Northeast of Brazil may underlie the clinical presentation of SpA in this region with a distinct clinical pattern characterized by combined axial and peripheral involvement and a more aggressive disease.

Disclosure:

P. D. Sampaio-Barros,
None;

M. Santiago,
None;

A. B. Bortoluzzo,
None;

A. C. Ximenes,
None;

J. A. Braga da Silva,
None;

M. B. Bértolo,
None;

S. L. Ribeiro,
None;

M. Keisermann,
None;

R. Menin,
None;

T. L. Skare,
None;

S. Carneiro,
None;

V. F. Azevedo,
None;

W. P. Vieira,
None;

E. Albuquerque,
None;

W. A. Bianchi,
None;

R. Bonfiglioli,
None;

C. Campanholo,
None;

H. M. Carvalho,
None;

I. P. Costa,
None;

A. L. B. P. Duarte,
None;

C. Kohem,
None;

N. Leite,
None;

S. Lima,
None;

E. S. Meirelles,
None;

I. A. Pereira,
None;

M. M. Pinheiro,
None;

E. Polito,
None;

G. G. Resende,
None;

F. A. Rocha,
None;

M. D. F. L. C. Sauma,
None;

V. Valim,
None;

C. R. Gonçalves,
None.

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