RESEARCH - First signs and symptoms of spondyloarthritis - data from an inception cohort with a disease course of 2 years or less: REGISPONSER-Early

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Rheumatology Advance Access published online on February 10, 2009

Rheumatology, doi:10.1093/rheumatology/ken506

First signs and symptoms of spondyloarthritis—data from an inception

cohort with a disease course of two years or less (REGISPONSER-Early)

Marena Rojas-Vargas1, Muñoz-Gomariz2, Escudero1, Pilar

Font1, Pedro Zarco3, Raquel Almodovar3, Jordi Gratacós4, Mulero5,

Xavier ola6, Montilla7, Estefanía Moreno8,

Collantes-Estevez1 and on behalf of REGISPONSER working group*

1Rheumatology Department, Hospital Universitario Reina Sofía, 2Unit

Methodology and Support to the Research (FIBICO), H. U. Reina Sofía,

Córdoba, 3Rheumatology Department, H. FUNDACIÓN de Alcorcón, Madrid,

4Rheumatology Department, H. Parc Taulí, Badalona, 5Rheumatology

Department, H. U. Puerta de Hierro, Madrid, 6Rheumatology Department,

H. U. Bellvitge, Barcelona, 7Rheumatology Department, H. Virgen de la

Vega, Salamanca and 8Rheumatology Department, H. San ,

Barcelona, Spain.

Objective. To determine the first signs and symptoms, and the

clinical, biological and radiological characteristics of patients with

early SpA.

Methods. A total of 150 SpA patients were selected from 2367 listed in

REGISPONSER (Registro Español de Espondiloartritis de la Sociedad

Española de Reumatología). The inclusion criterion was a disease

course of 2 yrs from the onset of symptoms or the appearance of the

first sign of disease.

Results. Forty-six patients had AS, 51 psoriatic SpA (Ps-SpA), 43

uSpA, 5 ReA, 4 IBD arthropathy and 1 JCA. The mean age at onset of

symptoms and at diagnosis was higher in Ps-SpA group (48.1 ± 13.6 and

48.5 ± 13.6 yrs) than in AS group (38.1 ± 12.8 and 38.9 ± 12.7 yrs)

and uSpA group (36.3 ± 11.5 and 36.9 ± 11.4 yrs). The most frequent

signs or symptoms were back pain: 72% AS group and 56% uSpA group.

Lower limb arthritis was the first symptom in 57% Ps-SpA patients, 35%

uSpA patients and 20% AS patients; upper limb arthritis was the first

symptom in 53% Ps-SpA group and <16% of the remainder. Compared with

longer duration disease, at onset, AS patients report upper limb

arthritis more frequently and uSpA patients report more of enthesitis.

Early radiological sacroiliitis was observed in all AS patients, of

whom 54% had Grade II, 39% had Grade III and 7% had Grade IV.

Conclusions. In our population, the first manifestations of SpA were

low back pain and SI syndrome in AS and uSpA patients and peripheral

arthritis in the Ps-SpA group. We can find early SI joint affectation

in AS patients.

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Read the full article here:

http://rheumatology.oxfordjournals.org/cgi/content/full/ken506v1

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