Early Axial Spondyloarthritis in Latin America: Prevalence and Regional Differences from the "ESPALDA" Multinational Registry

Wilson bautista molano¹, Guillermo Guaracha², Fernando Sommerfleck³, Rodrigo García Salinas⁴, Julio Cesar Casasola Vargas⁵, John Londono⁶, Daniel Fernandez⁷, Diego Vila⁸, Lorena Brance⁹, Jossiel Then¹⁰, francisco Zeballos¹¹, Lysseth Macias¹², Marilu mestanza¹³, Daisy Sanchez¹⁴, lYN chincháy¹⁵, Patricia Melgarejo¹⁶, Angel Castillo¹⁷, Gimena Gomez¹⁸, Leandro ferreryra¹⁹, Dora candia²⁰, Gustavo medina²¹, Maria Erguez²², Einer Sanchez⁴ and Daniel Palleiro²³, ¹University Hospital Fundacion Santa Fe de Bogota, Bogota, Colombia, ²Instituto Nacional de Ciencias Médicas y Nutrición 'Salvador Zubirán', Ciudad de México, Mexico, Mexico, ³Sanatorio Julio Mendez, Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina, ⁴Hospital Italiano La Plata, La Plata, Argentina, ⁵CAVJ^7111038Q⁹, MEXICO CITY, Mexico, ⁶Hospital Militar Central , Universidad de La Sabana, Colombia, Bogota, Colombia, ⁷Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia; Departamento de Medicina Interna, Unidad de Reumatología, Hospital Universitario San Ignacio, Bogotá, Colombia, BOGOTA, Colombia, ⁸Hospital Virgen del Carmen, Buenos Aires, Argentina, Buenos Aires, Argentina, ⁹School of Medicine, Rosario National University, Argentina, Rosario, Argentina, ¹⁰HOMS, Santiago, Dominican Republic, ¹¹Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru, ¹²Consultorio sse, Hospital Metropolitano, Ecuador, Quito, Ecuador, ¹³Hospital Metropolitano, Ecuador, Quito, Ecuador, ¹⁴Sociedad Ecuatoriana de Reumatología, GUAYAS - GUAYAQUIL, Ecuador, ¹⁵Hospital Guillermo Kaelin de La Fuente, Perú, Lima, Peru, ¹⁶Instituto de Previsión Social, Villarrica, Paraguay, ¹⁷Centro médico de las Americas, Merida, Mexico, ¹⁸Sanatorio Guemes, Buenos Aires, Argentina, ¹⁹HIBA, CABA, Ciudad Autonoma de Buenos Aires, Argentina, ²⁰Hospital Regional Primero de Octubre ISSTE, Fuerzas Armadas, México, Durango, Mexico, ²¹Clinical Hospital Buenos Aires University, Quilmes, Argentina, ²²SAR, Guayaquil, Ecuador, ²³INRU, Montevideo, Uruguay

Meeting: ACR Convergence 2025

Keywords: Data Management, Epidemiology, spondyloarthritis, Spondyloarthropathies

Session Information

Date: Tuesday, October 28, 2025

Title: (2305–2337) Spondyloarthritis Including Psoriatic Arthritis – Diagnosis, Manifestations, & Outcomes Poster III

Session Type: Poster Session C

Session Time: 10:30AM-12:30PM

Background/Purpose: The ESPALDA registry, developed by PANLAR, collects data from Latin America to better understand the clinical and epidemiological characteristics of patients with axial spondyloarthritis (axSpA). This analysis focuses on early axSpA, defined by ASAS criteria as a duration from the onset of back pain to diagnosis of less than two years, across the entire cohort and by region.

Methods: Patients aged ≥18 years meeting the ASAS 2009 criteria for axSpA were included. Data were collected from medical centers in nine LATAM countries. Baseline data included demographics, disease duration, clinical manifestations, comorbidities, disease activity (ASDAS, BASDAI), functionality (BASFI), laboratory tests (ESR, CRP, HLA-B27), and imaging (X-ray, MRI). Regions were categorized as South (Argentina, Chile, Uruguay, Paraguay), Andean (Colombia, Peru, Venezuela, Ecuador), and North (Mexico). Descriptive statistics and comparative analyses were performed using Chi-square tests and parametric or non-parametric methods as appropriate. Multivariable analysis was performed.

Results: In 419 patients, the prevalence of early axSpA was 31.49% (95% CI: 27.31% – 36.01%). Regional differences in prevalence were observed: South (38.19%), Andean (28.42%), and North (27.42%) (p=0.07). Differential characteristics of the entire cohort are detailed in Table 1. Multivariable analysis identified key factors positively associated with early axSpA: ASDAS high disease activity (HDA, OR = 17.808, 95% CI: 2.446 – 129.645, p=0.004) and BASDAI ≥4 (OR = 44.378, 95% CI: 4.943 – 398.394, p=0.001). Regional analyses highlighted distinct characteristics among early axSpA patients: South: Smoking (OR = 2.46, 95% CI: 1.30-4.64, p=0.01), positive sacroiliac maneuver (OR = 3.14, 95% CI: 1.58-6.26, p< 0.001), elevated CRP (OR = 2.25, 95% CI: 1.24-4.11, p=0.01), BASDAI (p< 0.001), and prolonged morning stiffness (p=0.01) were significantly associated. Andean: Enthesitis (OR = 4.73, 95% CI: 1.83-12.23, p< 0.001) was a key feature, while elevated CRP showed marginal significance (OR = 2.79, 95% CI: 1.02-7.62, p=0.08). North: Enthesitis (OR = 4.30, 95% CI: 1.59-11.64, p=0.01), elevated CRP (OR = 5.56, 95% CI: 2.34-13.26, p< 0.001), BASDAI (p=0.04), and prolonged morning stiffness (p=0.03) were highly distinctive, all variables in fig 1.

Conclusion: The ESPALDA registry highlights significant regional variations in early axSpA characteristics across LATAM.

Disclosures: W. bautista molano: None; G. Guaracha: None; F. Sommerfleck: None; R. García Salinas: AbbVie/Abbott, 2, 5, 6, Adium, 2, 5, 6, Amgen, 2, 5, 6, Biogen, 2, 5, 6, Bristol-Myers Squibb(BMS), 2, 5, 6, Eli Lilly, 2, 5, 6, GlaxoSmithKlein(GSK), 2, 5, 6, Janssen, 2, 5, 6, Novartis, 2, 5, 6, Pfizer, 2, 5, 6, Raffo, 2, 5, 6, Roche, 2, 5, 6, UCB, 2, 5, 6; J. Casasola Vargas: None; J. Londono: None; D. Fernandez: None; D. Vila: None; L. Brance: None; J. Then: None; f. Zeballos: None; L. Macias: None; M. mestanza: None; D. Sanchez: None; l. chincháy: None; P. Melgarejo: None; A. Castillo: None; G. Gomez: None; L. ferreryra: None; D. candia: None; G. medina: None; M. Erguez: None; E. Sanchez: None; D. Palleiro: None.

To cite this abstract in AMA style:

bautista molano W, Guaracha G, Sommerfleck F, García Salinas R, Casasola Vargas J, Londono J, Fernandez D, Vila D, Brance L, Then J, Zeballos f, Macias L, mestanza M, Sanchez D, chincháy l, Melgarejo P, Castillo A, Gomez G, ferreryra L, candia D, medina G, Erguez M, Sanchez E, Palleiro D. Early Axial Spondyloarthritis in Latin America: Prevalence and Regional Differences from the “ESPALDA” Multinational Registry [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/early-axial-spondyloarthritis-in-latin-america-prevalence-and-regional-differences-from-the-espalda-multinational-registry/. Accessed .

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