REGIONAL DIFFERENCES IN CLINICAL PHENOTYPE OF AXIAL SPONDYLOARTHRITIS. RESULTS FROM THE INTERNATIONAL MAP OF AXIAL SPONDYLOARTHRITIS (IMAS)
Authors: D. Poddubnyy et al.
This study using data from a cross-sectional online survey of more than 5500 axSpA patients from all over the world, aimed at analyzing differences of clinical phenotypes in different regions of the world. Whereas the classification status of radiographic vs non-radiographic was not different, the authors found significant differences of clinical parameters between the regions. HLA-B27 positivity was lowest in Latin America and highest in Asia. BASDAI was highest with 5.4 in South Africa and lowest in Asis, however, also the diagnostic delay was the highest in South Africa. Reported extramusculoskeletal manifestations were the lowest in Europe. Physical and mental comorbidities were more frequent in Africa as compared to Europe and Asia. Almost 50% of the patients had ever been treated with biologics, most frequently in the Americas.
This study shows a great heterogeneity of the clinical phenotypes of axSpA in different regions of the world. These interesting findings should motivate research into the pathogenesis and in particular the influence of environmental and societal factors to explain the regional differences. The findings may have impact on diagnostic and therapeutic approaches for axSpA in various regions of the world.