Fernando Sommerfleck, Rodrigo Garcia-Salinas, Diego Vila, Daniel Palleiro, Daniel G Fernández-Ávila, Julio César Casasola-Vargas, Yelena Sanchez-Canto, Liliana Candia, Nicolás Marín Zúcaro, Maria Lorena Brance, Lilith Stange, Joan Manuel Dapeña, Wilson Bautista-Molano
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引用次数: 0
摘要
尽管在拉丁美洲对轴性脊柱炎(axSpA)的认识不断增加,但区域性数据仍然很少。本研究旨在利用ESPALDA-PANLAR登记处的数据描述拉丁美洲axSpA的临床、实验室和影像学特征。采用ESPALDA登记处的基线数据进行横断面分析,该登记处包括七个拉丁美洲国家的axSpA患者。收集了人口统计学、临床、实验室和影像学资料。患者按性别、HLA-B27状态和放射学分类进行分层。采用多变量逻辑回归来确定独立关联。共纳入220例患者(56%为男性),平均年龄46岁,中位诊断延迟93个月(IQR: 13-122)。HLA-B27在60%的患者中呈阳性,62%的患者符合放射学axSpA分类标准。在多变量分析中,x线摄影axSpA与男性(OR 4.22; 95% CI 1.53-11.59)、MRI上的SI关节侵蚀(OR 3.98; 95% CI 1.45-10.90)和较长的诊断延迟(OR 1.01 /月;95% CI 1.00-1.01)独立相关。MRI显示HLA-B27阳性与骨髓水肿相关(OR 2.81; 95% CI 1.50-5.26),与牛皮癣呈负相关(OR 0.14; 95% CI 0.06-0.33)。ESPALDA登记处的第一份报告强调了axSpA在拉丁美洲的独特特征,包括较低的HLA-B27患病率和显著的诊断延迟。这些发现强调了早期认识和适应区域的诊断和管理策略的必要性。
Profile of patients with axial spondyloarthritis in Latin America: first report from the ESPALDA-PANLAR registry.
Despite increasing recognition of axial spondyloarthritis (axSpA) in Latin America, regional data remain scarce. This study aims to describe the clinical, laboratory, and imaging features of axSpA in Latin America using data from the ESPALDA-PANLAR registry. A cross-sectional analysis was conducted using baseline data from the ESPALDA registry, which includes patients with axSpA across seven Latin American countries. Demographic, clinical, laboratory, and imaging data were collected. Patients were stratified by sex, HLA-B27 status, and radiographic classification. Multivariable logistic regression was performed to identify independent associations. A total of 220 patients were included (56% male), with a mean age of 46 years and median diagnostic delay of 93 months (IQR: 13-122). HLA-B27 was positive in 60% of patients, and 62% met radiographic axSpA classification criteria. In multivariable analysis, radiographic axSpA was independently associated with male sex (OR 4.22; 95% CI 1.53-11.59), SI joint erosions on MRI (OR 3.98; 95% CI 1.45-10.90), and longer diagnostic delay (OR 1.01 per month; 95% CI 1.00-1.01). HLA-B27 positivity was associated with bone marrow edema on MRI (OR 2.81; 95% CI 1.50-5.26) and inversely with psoriasis (OR 0.14; 95% CI 0.06-0.33). This first report from the ESPALDA registry highlights distinctive features of axSpA in Latin America, including lower HLA-B27 prevalence and remarkably diagnostic delay. These findings underscore the need for earlier recognition and regionally adapted strategies for diagnosis and management.
期刊介绍:
RHEUMATOLOGY INTERNATIONAL is an independent journal reflecting world-wide progress in the research, diagnosis and treatment of the various rheumatic diseases. It is designed to serve researchers and clinicians in the field of rheumatology.
RHEUMATOLOGY INTERNATIONAL will cover all modern trends in clinical research as well as in the management of rheumatic diseases. Special emphasis will be given to public health issues related to rheumatic diseases, applying rheumatology research to clinical practice, epidemiology of rheumatic diseases, diagnostic tests for rheumatic diseases, patient reported outcomes (PROs) in rheumatology and evidence on education of rheumatology. Contributions to these topics will appear in the form of original publications, short communications, editorials, and reviews. "Letters to the editor" will be welcome as an enhancement to discussion. Basic science research, including in vitro or animal studies, is discouraged to submit, as we will only review studies on humans with an epidemological or clinical perspective. Case reports without a proper review of the literatura (Case-based Reviews) will not be published. Every effort will be made to ensure speed of publication while maintaining a high standard of contents and production.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.