Clinical characteristics of non-radiographic versus radiographic axial spondyloarthritis in Asia and non-radiographic axial spondyloarthritis in other regions: Results of the cross-sectional ASAS-COMOSPA study

Mitsumasa Kishimoto, Keisuke Ono, Sho Fukui, Satoshi Kawaai, Gautam A. Deshpande, Kazuki Yoshida, Naomi Ichikawa, Yuko Kaneko, Taku Kawasaki, Kazuo Matsui, Mitsuhro Morita, Kurisu Tada, Naoho Takizawa, Naoto Tamura, Atsuo Taniguchi, Yoshinori Taniguchi, Shigeyoshi Tsuji, Masato Okada, Shigeto Kobayashi, Yoshinori KomagataClementina López-Medina, Anna Molto, Desirée Van Der Heijde, Maxime Dougados, Tetsuya Tomita, Shinya Kaname

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Objectives To delineate characteristics of non-radiographic axial spondyloarthritis (nr-axSpA) in Asia versus non-Asian regions, and compare radiographic axSpA (r-axSpA) with nr-axSpA within Asia. Methods Data were collected from the Assessment of SpondyloArthritis international Society-COMOrbidities in SPondyloArthritis database. Categorising patients by region, we compared clinical characteristics between nr-axSpA from Asia vs elsewhere (Europe, the Americas and Africa). Within Asians, we additionally compared patient characteristics of those with nr-axSpA versus r-axSpA. Results Among 3984 SpA cases, 1094 were from Asian countries. Of 780 axSpA patients in Asia, 112 (14.4%) had nr-axSpA, less than in non-Asian countries (486/1997, 24.3%). Nr-axSpA patients in Asia were predominantly male (75.9% vs 47.1%), younger at onset (22.8 vs 27.8 years) and diagnosis (27.2 vs 34.5 years), and experienced less diagnostic delay (1.9 vs 2.9 years) compared with nr-axSpA in non-Asian countries. Nr-axSpA in Asia exhibited higher human leucocyte antigens-B27 prevalence (90.6% vs 61.9%), fewer peripheral SpA features (53.6% vs 66.3%) and similar extra-articular and comorbid disease rates compared with those with nr-axSpA in non-Asian countries. Disease activity, functional impairment and MRI sacroiliitis were less in nr-axSpA in Asia, with higher rates of non-steroidal anti-inflammatory drug response and less methotrexate and biological disease-modifying antirheumatic drugs use. Within Asia, r-axSpA showed higher disease activity and structural damage compared with nr-axSpA, with no differences in other features. Conclusion Among axSpA, lower frequency of nr-axSpA was observed in Asia. Our results offer an opportunity to better understand clinical characteristics and optimise diagnostic strategies, such as ensuring access and availability of MRI resources for accurate diagnosis of nr-axSpA in Asia.

Original languageEnglish
Article numbere001752
JournalRMD Open
Volume7
Issue number3
DOIs
Publication statusPublished - 2021 Sep 16

Keywords

  • ankylosing
  • arthritis
  • epidemiology
  • psoriatic
  • spondylitis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

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