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Title: Effect of age at disease onset in the clinical profile of spondyloarthritis: a study of 1424 Brazilian patients
Authors: Skare, T. L.
Leite, N.
Bortoluzzo, A. B.
Goncalves, C. R.
Silva, J. A. B. da
Ximenes, A. C.
Bertolo, M. B.
Ribeiro, Sandra Lúcia Euzébio [UNIFESP]
Keiserman, M.
Menin, R.
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.
Gavi, M. B. O.
Kohem, C. L.
Lima, S. A. L.
Meirelles, E. S.
Pereira, I. A.
Pinheiro, Marcelo de Medeiros [UNIFESP]
Polito, E.
Resende, G. G.
Rocha, F. A. C.
Santiago, M. B.
Sauma, M. F. L. C.
Sampaio-Barros, P. D.
Brazilian Registry Spondyloarthrit
Universidade de São Paulo (USP)
Hosp Evangel Curitiba
Fac Med Souza Marques
Insper Inst Educ & Res
Universidade de Brasília (UnB)
Hosp Geral Goiania
Universidade Estadual de Campinas (UNICAMP)
Univ Fed Amazonas
Pontificia Univ Catolica
Universidade Federal do Rio de Janeiro (UFRJ)
Univ Fed Parana
Hosp Geral Fortaleza
Universidade do Estado do Rio de Janeiro (UERJ)
Santa Casa Rio de Janeiro
Santa Casa Sao Paulo
Hosp Base
Universidade Federal de Mato Grosso do Sul (UFMS)
Universidade Federal de Pernambuco (UFPE)
Univ Fed Espirito Santo
Univ Fed Rio Grande do Sul
Hosp Servidor Publ Estadual
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
Fed Univ Para
Keywords: spondyloarthritis
ankylosing spondylitis
age at onset
Issue Date: 1-May-2012
Publisher: Clinical & Exper Rheumatology
Citation: Clinical And Experimental Rheumatology. Pisa: Clinical & Exper Rheumatology, v. 30, n. 3, p. 351-357, 2012.
Abstract: ObjectivesTo 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.MethodsA 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, 15.1 (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%).ResultsComparing 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 hack 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.ConclusionThere 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.
ISSN: 0392-856X
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