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Spectrum of ankylosing spondylitis in Portugal. Development of BASDAI, BASFI, BASMI and mSASSS reference centile charts

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Abstract

The availability of population-specific normative data regarding disease severity measures is essential for patient assessment. The goals of the current study were to characterize the pattern of ankylosing spondylitis (AS) in Portuguese patients and to develop reference centile charts for BASDAI, BASFI, BASMI and mSASSS, the most widely used assessment tools in AS. AS cases were recruited from hospital outpatient clinics, with AS defined according to the modified New York criteria. Demographic and clinical data were recorded. All radiographs were evaluated by two independent experienced readers. Centile charts for BASDAI, BASFI, BASMI and mSASSS were constructed for both genders, using generalized linear models and regression models with duration of disease as independent variable. A total of 369 patients (62.3% male, mean ± (SD) age 45.4 ± 13.2 years, mean ± (SD) disease duration 11.4 ± 10.5 years, 70.7% B27-positive) were included. Family history of AS in a first-degree relative was reported in 17.6% of the cases. Regarding clinical disease pattern, at the time of assessment 42.3% had axial disease, 2.4% peripheral disease, 40.9% mixed disease and 7.1% isolated enthesopatic disease. Anterior uveitis (33.6%) was the most common extra-articular manifestation. The centile charts suggest that females reported greater disease activity and more functional impairment than males but had lower BASMI and mSASSS scores. Data collected through this study provided a demographic and clinical profile of patients with AS in Portugal. The development of centile charts constitutes a useful tool to assess the change of disease pattern over time and in response to therapeutic interventions.

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References

  1. Braun J, Bollow M, Remlinger G et al (1998) Prevalence of spondylarthropathies in HLA-B27 positive and negative blood donors. Arthritis Rheum 41:58–67

    Article  PubMed  CAS  Google Scholar 

  2. Boonen A, van der Heijde D, Landewe R et al (2002) Work status and productivity costs due to ankylosing spondylitis: comparison of three European countries. Ann Rheum Dis 61:429–437

    Article  PubMed  CAS  Google Scholar 

  3. Lehtinen K (1993) Mortality and causes of death in 398 patients admitted to hospital with ankylosing spondylitis. Ann Rheum Dis 52:174–176

    Article  PubMed  CAS  Google Scholar 

  4. Garrett S, Jenkinson TR, Whitelock HC, Kennedy LG, Gaisford P, Calin A (1994) A new approach to defining disease status in AS: the Bath ankylosing spondylitis disease activity index (BASDAI). J Rheumatol 21:2286–2291

    PubMed  CAS  Google Scholar 

  5. Calin A, Garrett S, Whitelock HC et al (1994) A new approach to defining functional ability in ankylosing spondylitis: the development of Bath ankylosing spondylitis disease functional index (BASFI). J Rheumatol 21:2281–2285

    PubMed  CAS  Google Scholar 

  6. Jenkinson TR, Mallorie P, Whitelock HC, Kennedy LG, Calin A (1994) Defining spinal mobility in ankylosing spondylitis (AS): the Bath AS Metrological Index (BASMI). J Rheumatol 21:1694–1698

    PubMed  CAS  Google Scholar 

  7. Creemers MC, Franssen MJ, Van’t Hof MA, Gribnau FW, van de Putte LB, van Riel PL (2005) Assessment of outcome in ankylosing spondylitis: an extended radiographic scoring system. Ann Rheum Dis 64:127–129

    Article  PubMed  CAS  Google Scholar 

  8. Taylor AL, Balakrishnan C, Calin A (1998) Reference centile charts for measures of disease activity, functional impairment and metrology in ankylosing spondylitis. Arthritis Rheum 41:1119–1125

    Article  PubMed  CAS  Google Scholar 

  9. Thumboo J, Uramoto K, O’Fallon WM et al (2001) A comparative study of the clinical manifestations of systemic lupus erythematosus in Caucasians in Rochester, Minnesota, and Chinese in Singapore, from 1980 to 1992. Arthritis Rheum 45:494–500

    Article  PubMed  CAS  Google Scholar 

  10. van der Linden S, Valkenburgh HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis: a proposal for modification of the New York criteria. Arthritis Rheum 27:361–368

    Article  PubMed  Google Scholar 

  11. Sousa E, Sousa M, Pimentel F et al (2008) RESPONDIA. Ibero-American Spondyloarthropaties Registry: Portuguese group. Reumatol Clin 3(Suppl 4):S68–S72

    Google Scholar 

  12. Grupo de Consensos para as Terapêuticas Biológicas na Espondilite Anquilosante da Sociedade Portuguesa de Reumatologia Análise de doentes com Espondilite Anquilosante submetidos a terapêutica biológica registados na base de dados de agentes biológicos da Sociedade Portuguesa de Reumatologia. Acta Reumatol Port 2005;30:253–60.

  13. Khan MA (2003) Clinical features of ankylosing spondylitis. In: Hochberg M, Silman A, Smolen J, Weinblatt M, Weinblatt M (eds) Rheumatology. Mosby, London, pp 1161–1181

    Google Scholar 

  14. Collantes E, Zarco P, Munõz E et al (2007) Disease pattern of spondyloarthropathies in Spain: description of the first national registry REGISPONSER) extended report. Rheumatology 46:1309–1315

    Article  PubMed  CAS  Google Scholar 

  15. Khan MA, Van der Linden SM (1990) Ankylosing spondylitis and associated diseases. Rheum Dis Clin North Am 16:551–579

    PubMed  CAS  Google Scholar 

  16. Siepper J, Rudwaleit M (2005) Early referral recommendations for ankylosing spondylitis (including pre-radiographic and radiographic forms) in primary care. Ann Rheum Dis 64:659–663

    Article  Google Scholar 

  17. Feldkeller E, Khan MA, van der Heijde D, van der Linden S, Braun J (2003) Age at disease onset and diagnosis delay in HLA-B27 negative vs positive patients with ankylosing spondylitis. Rheumatol Int 23:61–66

    Google Scholar 

  18. Calin A, Elswood J, Rigg S, Skevington SM (1988) Ankylosing spondylitis—an analytical review of 1500 patients: the changing pattern of disease. J Rheumatol 15:1234–1238

    PubMed  CAS  Google Scholar 

  19. Kidd BL, Cawley MI (1988) Delay in diagnosis of spondarthritis. Br J Rheumatol 27:230–232

    Article  PubMed  CAS  Google Scholar 

  20. Rudwaleit M, van der Heijde D, Landewé R et al (2009) The development of Assessment of SpondyloArthritis International Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis 68:777–783

    Article  PubMed  CAS  Google Scholar 

  21. Strömbeck B, Jacobsson L, Bremander A et al (2009) Patients with ankylosing spondylitis have increased sick leave—a registry-based case–control study over 7 yrs. Rheumatology 48:289–292

    Article  PubMed  Google Scholar 

  22. Landewe R, Rump B, van der Heijde D, van der Linden S (2004) Which patients with ankylosing spondylitis should be treated with tumour necrosis factor inhibiting therapy? A survey among Dutch rheumatologists. Ann Rheum Dis 63:530–534

    Article  PubMed  CAS  Google Scholar 

  23. Pham T, Landewe RB, van der Linden S et al (2006) An International Study on Starting TNF-blocking agents in Ankylosing Spondylitis (ISSAS). Ann Rheum Dis 65:1620–1625

    Article  PubMed  CAS  Google Scholar 

  24. Cruyssen BV, Ribbens C, Boonen A et al (2007) The epidemiology of ankylosing spondylitis and the commencement of anti-TNF therapy in daily rheumatology practice. Ann Rheum Dis 66:1072–1077

    Article  Google Scholar 

  25. Kennedy LG, Edmunds I, Calin A (1993) The natural history of ankylosing spondylitis: does it burn out? J Rheumatol 20:688–692

    PubMed  CAS  Google Scholar 

Download references

Acknowledgements

We would like to thank the individuals who shared their clinical data with us to complete this study and to ANEA (Ankylosing Spondylitis Portuguese Patients Association) and to all Portuguese Rheumatologists involved in CORPOREA Study Group. This study was supported by Bolsa de Investigação da Sociedade Portuguesa de Reumatologia/Schering-Plough 2007; FCML 2007 Grant and Wyeth Lederle Portugal Grant.

CORPOREA Study Group: Centro Hospitalar de Lisboa Ocidental, Hospital de Egas Moniz EPE, Lisboa: A F Mourão, AA de Matos, C Ribeiro, FM Pimentel-Santos, J Bravo Pimentão, JC Branco, M Mateus, P Nero, P Araújo, S Falcão, TL Pinto, W Castelão. Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa: E Vieira de Sousa, J Caetano-Lopes, JE Fonseca. Instituto Português de Reumatologia, Lisboa: C Silva, E Simões, H Madeira, H Santos, J Vaz Patto, J Ferreira, M Micaelo, MJ Mediavilla, M Sousa, Hospital Curry Cabral EPE, Lisboa: P Soares Branco. Hospital Garcia de Orta EPE, Almada: F Godinho, J Canas da Silva, S Garcês, V Tavares. Centro Hospitalar do Alto Minho, Hospital Conde de Bertiandos EPE, Ponte de Lima: A Ribeiro, D Araújo, JA Costa, L Costa, MC Afonso, M Bogas, S Alcino. Centro Hospitalar de Vila Nova de Gaia/Espinho EPE, Vila Nova de Gaia: P Pinto. Hospital de Faro EPE, Faro: AR Cravo, G Sequeira. Hospital Militar Principal, Lisboa: RA Santos. Centro Hospitalar Baixo Vouga, Hospital Infante D. Pedro EPE: A Barcelos, I Cunha. Centro Hospitalar Oeste Norte, Centro Hospitalar das Caldas da Rainha: M Cruz.

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Author information

Authors and Affiliations

  1. CEDOC, Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisbon, Portugal

    Fernando M. Pimentel-Santos, Ana Filipa Mourão & Jaime C. Branco

  2. Instituto de Biotecnologia e Bioengenharia, Centro de Genética e Biotecnologia, Universidade de Trás-os-Montes e Alto Douro (IBB/CGB—UTAD), Vila Real, Portugal

    Fernando M. Pimentel-Santos & Henrique Guedes-Pinto

  3. Centro Hospitalar Lisboa Ocidental (CHLO), Hospital de Egas Moniz, Lisbon, Portugal

    Fernando M. Pimentel-Santos, Ana Filipa Mourão, Célia Ribeiro & Jaime C. Branco

  4. Centro Hospital do Alto Minho (CHAM), Hospital Conde de Bertiandos, Ponte de Lima, Portugal

    José Costa

  5. Instituto Português de Reumatologia (IPR), Lisbon, Portugal

    Helena Santos

  6. Hospital Infante D. Pedro, Aveiro, Portugal

    Anabela Barcelos

  7. Hospital de São Marcos, Braga, Portugal

    Patricia Pinto

  8. Hospital Garcia de Orta, Almada, Portugal

    Fátima Godinho

  9. Centro Hospitalar das Caldas da Rainha, Caldas da Rainha, Portugal

    Margarida Cruz

  10. Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular (IMM), Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal

    Elsa Vieira-Sousa & João Eurico Fonseca

  11. Centro Hospitalar Lisboa Norte (CHLN), Hospital de Santa Maria, Lisbon, Portugal

    Elsa Vieira-Sousa & João Eurico Fonseca

  12. Hospital Militar Principal, Lisbon, Portugal

    Rui André Santos

  13. EXIGO Consultores, Alhos Vedros, Portugal

    Sara Rabiais & Jorge Félix

  14. Diamantina Institute for Cancer, Immunology and Metabolic Medicine, Princess Alexandra Hospital, University of Queensland, Brisbane, Australia

    Matthew A Brown

Authors
  1. Fernando M. Pimentel-Santos
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  2. Ana Filipa Mourão
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  3. Célia Ribeiro
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  4. José Costa
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  5. Helena Santos
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  6. Anabela Barcelos
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  7. Patricia Pinto
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  8. Fátima Godinho
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  9. Margarida Cruz
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  10. Elsa Vieira-Sousa
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  11. Rui André Santos
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  12. Sara Rabiais
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  13. Jorge Félix
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  14. João Eurico Fonseca
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  15. Henrique Guedes-Pinto
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  16. Matthew A Brown
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  17. Jaime C. Branco
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Consortia

CORPOREA Study Group

Corresponding author

Correspondence to Fernando M. Pimentel-Santos.

Additional information

Matthew A Brown and Jaime C Branco equally contributed to this study.

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Pimentel-Santos, F.M., Mourão, A.F., Ribeiro, C. et al. Spectrum of ankylosing spondylitis in Portugal. Development of BASDAI, BASFI, BASMI and mSASSS reference centile charts. Clin Rheumatol 31, 447–454 (2012). https://doi.org/10.1007/s10067-011-1854-7

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  • DOI: https://doi.org/10.1007/s10067-011-1854-7

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