Effect of age at disease onset in the clinical profile of spondyloarthritis: a study of 1424 Brazilian patients

To analyse demographic and clinical variables in patients with disease onset before and after 40, 45 and 50 years in a large series of Brazilian SpA patients. A common protocol of investigation was prospectively applied to 1424 SpA patients in 29 centres distributed through the main geographical reg...

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Published in:	Clinical and experimental rheumatology Vol. 30; no. 3; pp. 351 - 357
Main Authors:	SKARE, T. L, LEITE, N, CARNEIRO, S, AZEVEDO, V. F, VIEIRA, W. P, ALBUQUERQUE, E. N, BIANCHI, W. A, BONFIGLIOLI, R, CAMPANHOLO, C, CARVALHO, H. M. S, COSTA, I. P, DUARTE, A. P, BORTOLUZZO, A. B, GAVI, M. B. O, KOHEM, C. L, LIMA, S. A. L, MEIRELLES, E. S, PEREIRA, I. A, PINHEIRO, M. M, POLITO, E, RESENDE, G. G, ROCHA, F. A. C, SANTIAGO, M. B, GONCALVES, C. R, SAUMA, M. F. L. C, SAMPAIO-BARROS, P. D, DA SILVA, J. A. B, XIMENES, A. C, BERTOLO, M. B, RIBEIRO, S. L. E, KEISERMAN, M, MENIN, R
Format:	Journal Article
Language:	English
Published:	Pisa Clinical and Experimental Rheumatology 01-05-2012
Subjects:	Adolescent Adult Age Distribution Age of Onset Aged Biological and medical sciences Brazil - epidemiology Child Child, Preschool Diseases of the osteoarticular system Diseases of the spine Female Humans Infant Infant, Newborn Inflammatory joint diseases Male Medical sciences Middle Aged Prospective Studies Severity of Illness Index Spondylarthritis - epidemiology Spondylarthritis - physiopathology Spondylitis, Ankylosing - epidemiology Spondylitis, Ankylosing - physiopathology Young Adult Brazil Human Prognosis Diseases of the osteoarticular system Rheumatology Inflammatory joint disease Spine disease Spondylarthropathy Symptomatology spondyloarthritis Chronic age at onset Age Ankylosing spondylitis outcome
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Summary:	To analyse demographic and clinical variables in patients with disease onset before and after 40, 45 and 50 years in a large series of Brazilian SpA patients. A common protocol of investigation was prospectively applied to 1424 SpA patients in 29 centres distributed through the main geographical regions in Brazil. The mean age at disease onset was 28.56 ± 12.34 years, with 259 patients (18.2%) referring disease onset after 40 years, 151 (10.6%) after 45 years and 81 (5.8%) after 50 years. Clinical and demographic variables and disease indices (BASDAI, BASFI, BASRI, MASES, ASQoL) were investigated. Ankylosing spondylitis was the most frequent disease (66.3%), followed by psoriatic arthritis (18%), undifferentiated SpA (6.7%), reactive arthritis (5.5%), and enteropathic arthritis (3.5%). Comparing the groups according to age of disease onset, those patients with later onset presented statistical association with female gender, peripheral arthritis, dactylitis, nail involvement and psoriasis, as well as negative statistical association with inflammatory low back pain, alternating buttock pain, radiographic sacroiliitis, hip involvement, positive familial history, HLA-B27 and uveitis. BASDAI, BASFI and quality of life, as well as physicians and patient's global assessment, were similar in all the groups. Radiographic indices showed worse results in the younger age groups. There are two different clinical patterns in SpA defined by age at disease onset: one with predominance of axial symptoms in the group with disease onset ≤ 40 years and another favouring the peripheral manifestations in those with later disease onset.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0392-856X 1593-098X