Session Type: Poster Session (Sunday)
Session Time: 9:00AM-11:00AM
Background/Purpose: Spondyloarthritis (Spa) is an heterogeneous group of diseases. Diagnostic delay contributes to poor patient outcome. Prompt diagnosis of Spa is the first step towards optimal patient management. The aims of the study were to determinate if there were difference in diagnostic delay of Spa before 2010 vs 2010-2019 and to identify features associated with diagnostic delay more than twelve months.
Methods: Cross-sectional, analytical, multi-center study. Patients older than 18 years, fulfilling ASAS criteria were inclued. Socio-demographic and clinical features, comorbidities and treatments were recorded. Disease activity: patient´s global assessment (GA), physician´s GA; peripheral: joint count (SJC66/TJC68), enthesis evaluation (LEI) and DAS28; axial: BASDAI, ASDAS-ERS, SASDAS-ERS, functional assessment by BASFI. Disability by HAQ; Quality of life by ASQol and global health status by ASAS Health Index. Statistical analysis: descriptive statistics, Mann-Whitney or T-test for continuous variables and Fisher’s exact test or Chi2 for categorical ones, p 0.05 was considered significant. STATA 14.
Results: Two hundred one patients were inclued, 55.7% were males, mean age 48.8 years old (SD 14.3), median evolution time 65 months (IQR 24-132), median BMI 27.3 (IQR 22.7-35.8). More than half had peripheral involvement (53.73%). The 51.74% had enthesitis (n 101), 34.33% had dactylitis (n 69). Ninety-nine (49.5%) had psoriatic arthritis, 4.98% (n 10) inflammatory bowel disease and 13.93% (n 28) uveitis. Before 2010: diagnostic delay was longer than after 2010 [median 48 months (IQR 12-84) vs 12 months (IQR 4-24) p 0.000]. The greater diagnostic delay was associated to older patients [56 years old (IQR 42-64) vs 47 years old (34-56) p 0.001] and more of them loosed their job (p: 0.001). Diagnostic delay more than twelve months were associated with more prevalence of hypertension [39.3% vs 18.06% p: 0.003], loss of work [43.82 vs 23.61% p: 0.006] and use of biologics [58.43% vs 28.89% p: 0.010]. We did not find differences in disease activity, disability, quality of life or global health status by ASAS Health Index between both groups.
Conclusion: In recent years we have considerably improved the diagnosis delay of Spa. Even twelve months’ delay was associated with loss of work, more comorbidities (hypertension) and greater use of biological treatments. ASAS criteria and the best knowledge of our diseases have contributed to this improvement.
To cite this abstract in AMA style:Scarafia S, Girard Bosch M, Benegas M, Cosentino V, Marin J, Duarte V, Bande J, Gamba M, Sommerfleck F, Gonzalez P, Vila D, Oliver M, Piovesan M, Aguila R, Edson Javier V, Kerzberg E, Tapia Moreira M, Cosatti M, Airoldi C, Garcia M, Martire M. Diagnostic Delay in Spondyloarthritis [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/diagnostic-delay-in-spondyloarthritis/. Accessed May 28, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/diagnostic-delay-in-spondyloarthritis/