Rheumatology (Oxford). 2021 Jul 14:keab544. doi: 10.1093/rheumatology/keab544. Online ahead of print.
ABSTRACT
OBJECTIVES: Age at onset is useful in identifying chronic back patients at an increased risk of axial spondyloarthritis (axSpA). Yet, the majority of data on which the age at onset <45 years criterion was based originates from Europe. Therefore, it is unknown if this criterion applies in other parts of the world. We aimed to assess age at onset of axSpA and its relationship with HLA-B27 and gender across the world.
METHODS: Analyses were applied to patients from 24 countries across the world with an axSpA diagnosis and known age at onset of axial complaints. Cumulative probability plots were used to display the cumulative distribution of age at onset of axial symptoms. Linear regression models were built to assess the effect of HLA-B27 and gender on age at onset of axial symptoms.
RESULTS: 92% of 2,579 axSpA patients had an age at onset of axial symptoms <45 years, with only small variations across the geographical regions (Asia [n = 574; 94%], Europe & North America [n = 988; 92%], Latin America [n = 246; 89%], and Middle East & North Africa [n = 771; 91%]). Age at onset of axial symptoms was consistently lower in HLA-B27 positive patients (median 25[19-32] vs 31[22-39]) and male patients (median 25[19-33] vs 28[21-37]), but in multivariable models an additional statistically significant effect of male gender independent of HLA-B27 was only found in Asia.
CONCLUSION: Around the world, the large majority of axSpA patients had an age at onset of axial disease <45, with HLA-B27 and male gender associated with earlier disease onset.
PMID:34260699 | DOI:10.1093/rheumatology/keab544
