Epidemiology of Spondyloarthritis

Spondyloarthritis (SpA) represents a group of interrelated diseases with common clinical features and a close association with HLA-B27. Reports of incidence and prevalence of diseases vary depending on methodological differences between studies, the case definition used to classify disease, and the prevalence of HLA-B27 in the population studied. Newly proposed criteria for axial SpA and peripheral SpA present a new approach to facilitate classification of the SpA into 2 main subtypes and the criteria allow earlier detection of patents with inflammatory back pain. These criteria were developed for use in a (specialized) clinical setting and not for large epidemiologic studies.

Key Points

  • Data on incidence and prevalence become increasingly important not only for clinicians when trying to understand disease patterns but also for policy makers for whom the prevalence of a disease has immediate impact on societal budgets and on population health. Hence, there is a need for accurate data on incidence and prevalence.

  • The variation in incidence and prevalence of spondyloarthritis (SpA) as a disease and the SpA subtypes varies highly and this cannot only be attributed to geographic variation in the prevalence of HLA-B27. Because part of this variation likely is explained by variation in quality and bias of the methodologic approaches, the recent generic guidelines for performance of studies on incidence and prevalence could be adapted for use in the SpA.

  • A particular challenge is to agree on a series of approaches with an acceptable (low) risk of bias that could operationalize the current classification criteria (which are developed for use in a [specialized] clinical setting) for use in large epidemiologic studies.

  • Although a large part of the SpA subtypes in epidemiologic studies are classified as undifferentiated SpA (uSpA), this diagnosis will likely disappear with the acceptance of new concepts and classification of axial SpA and peripheral SpA. The application of these criteria in epidemiologic studies requires further consideration.

  • Few data are available on the prevalence of inflammatory bowel disease (IBD)-related SpA and reactive arthritis (ReA). The new peripheral SpA criteria will likely encompass both entities, but the transient nature of ReA makes prevalence estimates challenging.

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Oct 1, 2017 | Posted by in RHEUMATOLOGY | Comments Off on Epidemiology of Spondyloarthritis

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