Session Information
Date: Monday, October 22, 2018
Title: Spondyloarthritis Including Psoriatic Arthritis – Clinical Poster II: Clinical/Epidemiology Studies
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Familial aggregation of the SpA in particular AS has long been known and up to 40% of AS patients have a positive family history of SpA. However differences in disease expression in familial and sporadic cases were evaluated in a few studies and there are some discrepancies among those reports. Therefore our aim was to explore the frequency of familial cases in our axial SpA (axSpA) patients and to evaluate the effects of family history of SpA according to the ASAS recommendations on disease phenotype.
Methods: In total 526 patients with axSpA (325 [62%] male; mean age 42.3 ± 11.9 years) followed up in one center were included in the analysis. The study group was consisting 358 (68%) AS and 168 (32%) non radiographic-axSpA patients. Family history of SpA is determined as in ASAS classification criteria and defined as the presence of any of the followings in the first or second-degree relatives; AS, acute anterior uveitis (AAU), ReA, psoriasis, or IBD. Demographic data and disease related characteristics including disease activity, function, quality of life and spinal mobility were collected with a structured method. Structural damage was evaluated by using modified Stoke Ankylosing Spondylitis Spine Score (mSASSS).
Results: 134 (25.5%) of our patients had family history of SpA. AS (102/134; 76.1%) and psoriasis (46; 34.3%) were most frequently found diseases in family history. 89 patients (66%) had affected FDR and 40 (29.8%) had more than one affected family member. Female sex, psoriasis and HLA-B27 positivity were more frequent in familial cases in comparison with sporadic ones. They also had longer symptom duration (Table). However other disease related characteristics including disease activity, spinal mobility and structural damage at the time of assessment were similar between familial and sporadic axSpA patients. Among patients with positive family history, men had higher mSASSS scores (19.0 ± 26.1 vs 3.4 ± 12.4 p<0.001) than women. However in sporadic cases this was not statistically significant (19.0 ± 26.1 vs 14.6 ± 22.8 p: 0.481).
Conclusion: In our study group familial axSpA had longer disease duration and more frequent HLA-B27 positivity. However disease expression including functional limitation and structural damage did not differ between familial and sporadic cases.
Table 1 Demographics and clinical features Axial Spondyloarthritis patient with or without family history
|
Variables |
Familial axSpA patients (n=134) |
Sporadic axSpA patients (n=392) |
P |
|
Age; mean ± SD |
43.7 ± 12.0 |
41.8 ± 11.8 |
0.086 |
|
Female; % |
47.0 |
35.2 |
0.015 |
|
Symptom duration; mean ± SD |
16.6 ± 11.7 |
13.6 ± 9.4 |
0.018 |
|
Delay in diagnosis; |
7.4 ± 8.7 |
6.7 ± 7.4 |
0.379 |
|
Smoking (ever); % |
71.6 |
70.5 |
0.797 |
|
BMI ; mean ± SD |
26.6 ± 4.8 |
26.4 ± 8.8 |
0.135 |
|
Peripheral arthritis (ever), % |
49/132; 37.1 |
121/346; 35.0 |
0.661 |
|
Enthesitis (ever), % |
53.4 |
48.4 |
0.380 |
|
Dactylitis (ever), % |
1.5 |
2.3 |
0.734 |
|
Uveitis (ever), % |
11.9 |
10.9 |
0.750 |
|
Psoriasis, % |
12.0 |
2.3 |
<0.001 |
|
IBD, % |
2.3 |
3.4 |
0.762 |
|
IBP (any criteria), % |
88.8 |
91.3 |
0.400 |
|
NSAID response rate, % |
89.2 |
89.1 |
0.983 |
|
HLA B27 positivity, % |
71.2 (74/104) |
57.4 (155/270) |
0.018 |
|
CRP mg/dl; mean ± SD |
13.6 ± 21.0 |
15.5 ± 23.6 |
0.261 |
|
BASFI; mean ± SD |
3.7 ± 2.8 |
3.5 ± 2.7 |
0.374 |
|
BASDAI; mean ± SD |
4.4 ± 2.3 |
4.2 ± 2.3 |
0.615 |
|
ASDAS-CRP; mean ± SD |
2.9 ± 1.1 |
2.9 ± 1.1 |
0.755 |
|
BASMI; mean ± SD |
2.8 ± 2.2 |
2.6 ± 2.2 |
0.493 |
|
mSSASS; mean ± SD |
12.2 ± 22.5 |
11.8 ± 20.8 |
0.649 |
|
Presence of syndosmophyte , % |
55.3 (52/94) |
60.9 (176/289) |
0.338 |
|
Hip involvement , % |
14.2 (18/127) |
20.5 (76/369) |
0.117 |
To cite this abstract in AMA style:
Solmaz D, Gercik O, Kabadayı G, Akar S. The Disease Expression in Familial and Sporadic Axial Spondyloarthritis Patients [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/the-disease-expression-in-familial-and-sporadic-axial-spondyloarthritis-patients/. Accessed .« Back to 2018 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-disease-expression-in-familial-and-sporadic-axial-spondyloarthritis-patients/