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Title: Ethnic Influence in Clinical and Functional Measures of Brazilian Patients with Spondyloarthritis
Authors: Skare, Thelma L.
Bortoluzzo, Adriana B.
Goncalves, Celio R.
Braga da Silva, Jose Antonio
Ximenes, Antonio Carlos
Bertolo, Manoel B.
Ribeiro, Sandra L. E.
Keiserman, Mauro
Menin, Rita
Carneiro, Sueli
Azevedo, Valderilio F.
Vieira, Walber P.
Albuquerque, Elisa N.
Bianchi, Washington A.
Bonfiglioli, Rubens
Campanholo, Cristiano
Carvalho, Hellen M. S.
Costa, Izaias P.
Duarte, Angela P.
Gavi, Maria Bernadete O.
Kohem, Charles L.
Leite, Nocy H.
Lima, Sonia A. L.
Meirelles, Eduardo S.
Pereira, Ivanio A.
Pinheiro, Marcelo M. [UNIFESP]
Polito, Elizandra
Resende, Gustavo G.
Rocha, Francisco Airton C.
Santiago, Mittermayer B.
Sauma, Maria de Fatima L. C.
Sampaio-Barros, Percival D.
Universidade de São Paulo (USP)
Hosp Evangel Curitiba
Insper Inst Educ & Res
Universidade de Brasília (UnB)
Hosp Geral Goiania
Universidade Estadual de Campinas (UNICAMP)
Univ Fed Amazonas
Pontificia Univ Catolica Porto Alegre
Universidade Federal do Rio de Janeiro (UFRJ)
Universidade do Estado do Rio de Janeiro (UERJ)
Univ Fed Parana
Hosp Geral Fortaleza
Santa Casa Rio de Janeiro
Pontificia Univ Catolica Campinas
Santa Casa São Paulo
Universidade Federal de Mato Grosso do Sul (UFMS)
Universidade Federal de Pernambuco (UFPE)
Univ Fed Espirito Santo
Univ Fed Rio Grande do Sul
Universidade Federal de Santa Catarina (UFSC)
Universidade Federal de São Paulo (UNIFESP)
Santa Casa Belo Horizonte
Universidade Federal de Minas Gerais (UFMG)
Univ Fed Ceara
Escola Med & Saude Publ Salvador
Fed Univ Para
Issue Date: 1-Jan-2012
Publisher: J Rheumatol Publ Co
Citation: Journal of Rheumatology. Toronto: J Rheumatol Publ Co, v. 39, n. 1, p. 141-147, 2012.
Abstract: Objective. Spondyloarthritides (SpA) can present different disease spectra according to ethnic background. the Brazilian Registry of Spondyloarthritis (RBE) is a nationwide registry that comprises a large databank on clinical, functional, and treatment data on Brazilian patients with SpA. the aim of our study was to analyze the influence of ethnic background in SpA disease patterns in a large series of Brazilian patients.Methods. A common protocol of investigation was prospectively applied to 1318 SpA patients in 29 centers distributed through the main geographical regions in Brazil. the group comprised whites (65%), African Brazilians (31.3%), and people of mixed origins (3.7%). Clinical and demographic variables and various disease index scores were compiled. Ankylosing spondylitis (AS) was the most frequent disease in the group (65.1%); others were psoriatic arthritis (18.3%), undifferentiated SpA (6.8%), enteropathic arthritis (3.7%), and reactive arthritis (3.4%).Results. White patients were significantly associated with psoriasis (p = 0.002), positive HLA-B27 (p = 0.014), and use of corticosteroids (p < 0.0001). Hip involvement (p = 0.02), axial inflammatory pain (p = 0.04), and radiographic sacroiliitis (p = 0.025) were associated with African Brazilian descent. Sex distribution, family history, and presence of peripheral arthritis, uveitis, dactylitis, urethritis, and inflammatory bowel disease were similar in the 3 groups, as well as age at disease onset, time from first symptom until diagnosis, and use of anti-tumor necrosis factor-a agents (p > 0.05). Schober test and thoracic expansion were similar in the 3 groups, whereas African Brazilians had higher Maastricht Ankylasing Spondylitis Enthesitis Scores (p = 0.005) and decreased lateral lumbar flexion (p = 0.003), while whites had a higher occiput-to-wall distance (p = 0.02). African Brazilians reported a worse patient global assessment of disease (p = 0.011). Other index scores and prevalence of work incapacity were similar in the 3 groups, although African Brazilians had worse performance in the Ankylosing Spondylitis Quality of Life questionnaire (p < 0.001).Conclusion. Ethnic background is associated with distinct clinical aspects of SpA in Brazilian patients. African Brazilian patients with SpA have a poorer quality of life and report worse disease compared to whites, (First Release Nov 1 2011; J Rheumatol 2012;39:141-7; doi:10.3899/jrheum.110372)
ISSN: 0315-162X
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