Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose:
Spondyloarthritis (SpA), a group of inflammatory diseases which exhibit similar genetic background, clinical features and symptoms1, has an estimated prevalence of 0.5-1%2 in Spain. However, in first-degree relatives positive for the HLA-B27 antigen, this prevalence may reach up to 24%3-7. The ASAS (Assessment of SpondyloArthritis international Society) criteria for SpA facilitate the identification of patients throughout the SpA spectrum, helping to potentially diagnose SpA features in first-degree relatives of patients with ankylosing spondylitis (AS). The aim of this study was to determine the prevalence of axial and peripheral SpA in first-degree relatives of AS patients.
Methods:
A multicentre, cross-sectional prevalence study was designed in first-degree relatives of patients with AS. Relatives agreeing to participate in the study completed a screening questionnaire to identify the presence of specific SpA characteristics. Relatives whose responses indicated the presence of SpA features were referred to a rheumatologist to collect their medical history and an assessment of disease activity, which included a blood test for the HLA-B27 antigen and C-reactive protein (CRP), a simple pelvic X-ray (Rx) and a pelvic magnetic resonance image (MRI). All the imaging tests were assessed by an expert radiologist.
Results:
Of the 486 participants, 290 first-degree relatives were classified as positive for SpA features after the screening questionnaire, and 269 continued in the study. After a rheumatologist’s evaluation using the ASAS criteria (table 1), 55 participants had no apparent signs of SpA and 214 were considered to be evaluable by the rheumatologist. Supplementary tests were performed in 195 relatives. Approximately 10.9% (n=53/486) of all the relatives met the criteria for SpA, of whom 60% (n=32) and 40% (n=21) were diagnosed as having? axial SpA and peripheral SpA, respectively. Of the relatives assessed for diagnosis (n=250), 21.2% (n=53) met the criteria for SpA; 12.8% (n=32) were diagnosed with axial SpA, 8.4% (n=21) with peripheral SpA (table 2).
Approximately 62.5% (n=20) of the 32 relatives with axial SpA met criteria for axial SpA through the clinical arm, 15.6% (n=5) met the imaging criteria, and 21.9% (n=7) met both the clinical and imaging criteria (table 2).
Conclusion:
The incidence of SpA in first-degree relatives of Spanish patients with AS was 10.9%, which is consistent with the published literature.
TABLES
Table 1: Assessed ASAS criteria rates
|
Relatives Screening + |
n |
% |
N |
|
Inflammatory back pain |
193 |
39.7% |
486 |
|
Arthritis |
37 |
7.6% |
486 |
|
Enthesitis of the heel |
50 |
10.3% |
486 |
|
Uveitis |
6 |
1.2% |
486 |
|
Dactylitis |
13 |
2.7% |
486 |
|
Psoriasis |
14 |
2.9% |
486 |
|
Crohn’s disease/colitis |
3 |
0.6% |
486 |
|
Good response to NSAIDs |
171 |
35.2% |
486 |
|
Relatives evaluated |
n |
% |
N |
|
HLA-B27 Positive |
79 |
40.5% |
195 |
|
Elevated CRP |
37 |
19.0% |
195 |
|
Sacroiliitis in imaging |
18 |
8.9% |
195 |
Table 2: Distribution of relatives evaluated for SpA diagnosis
|
|
n |
%1 |
|
Relative screening + assessed for diagnosis |
250 |
100.0 |
|
Do not meet spondyloarthritis criteria |
197 |
78.8% |
|
Meet spondyloarthritis criteria |
53 |
21.2% |
|
-Axial spondyloarthritis |
32 |
12.8% |
|
-Peripheral spondyloarthritis |
21 |
8.4% |
|
Axial SpA |
32 |
100% |
|
Only HLA B27+ |
20 |
62.5% |
|
Onl y MRI + |
5 |
15.6% |
|
Both |
7 |
21.9% |
Disclosure:
R. Menor Almagro,
None;
C. Ordas,
None;
C. Montilla,
None;
J. L. Alvarez-Vega,
None;
Hernández-Rodríguez,
None;
M. Corteguera,
None;
S. MuÑoz Fernandez,
None;
C. Urrego,
None;
R. Ariza-Ariza,
None;
M. Moreno,
None;
X. Juanola,
None;
M. I. Tévar,
None;
E. Collantes- Estevez,
None;
J. Mulero- Mendoza,
None;
A. Ruiz-Zorrilla,
Abbvie,
3.
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