title: Comparison of the clinical expression of patients with ankylosing spondylitis from Europe and Latin America.
abstract: OBJECTIVE
  To compare the clinical, demographic, and serologic characteristics and the treatment of patients diagnosed with ankylosing spondylitis (AS) from Europe (EU) and Latin America (LA).
  
  
  METHODS
  We included 3439 patients from national registries: the Spanish Registry of Spondyloarthritis (REGISPONSER), the Belgian registry (ASPECT), and the Latin American Registry of Spondyloarthropathies (RESPONDIA). We selected patients with diagnosis of AS who met the modified New York classification criteria. Demographic, clinical, disease activity, functional, and metrological measurement data were recorded. Current treatment was recorded. The population was classified into 2 groups: patients with disease duration < 10 years and those with disease duration ≥ 10 years. A descriptive and comparative analysis of variables of both groups was carried out.
  
  
  RESULTS
  There were 2356 patients in EU group and 1083 in LA group. Prevalence of HLA-B27 was 71% in LA group and 83% in EU group (p < 0.001). We found a greater frequency of peripheral arthritis and enthesitis (p < 0.001) in the LA population; prevalence of arthritis was 57% in LA and 42% in EU, and for enthesitis, 54% and 38%. Except for treatment with anti-tumor necrosis factor (anti-TNF), the use of nonsteroidal antiinflammatory drugs (NSAID), corticosteroids, and disease-modifying antirheumatic drugs (DMARD), and the association of anti-TNF and methotrexate use showed a significant difference (p < 0.001) in the 2 populations.
  
  
  CONCLUSIONS
  The principal differences in the clinical manifestations of patients with AS from EU and LA were the greater frequency of peripheral arthritis and enthesitis in LA group, the higher percentage of HLA-B27 in EU group, and the form of treatment, with a greater use of NSAID, steroids, and DMARD in the LA group.
authors.affiliation: Rheumatology Section, Dr. E. Tornú Hospital, Buenos Aires, Argentina, Mexico. mbenegas07@yahoo.com.ar
authors.forename: Mariana
authors.initials: M
authors.lastname: Benegas
authors.forename: Elisa
authors.initials: E
authors.lastname: Muñoz-Gomariz
authors.forename: Pilar
authors.initials: P
authors.lastname: Font
authors.forename: Ruben
authors.initials: R
authors.lastname: Burgos-Vargas
authors.forename: José
authors.initials: J
authors.lastname: Chaves
authors.forename: Daniel
authors.initials: D
authors.lastname: Palleiro
authors.forename: José
authors.initials: J
authors.lastname: Maldonado Cocco
authors.forename: Miguel
authors.initials: M
authors.lastname: Gutiérrez
authors.forename: Ricardo
authors.initials: R
authors.lastname: Sáenz
authors.forename: Ivan
authors.initials: I
authors.lastname: Steckmen
authors.forename: Oscar
authors.initials: O
authors.lastname: Rillo
authors.forename: Juan
authors.initials: J
authors.lastname: Mulero
authors.forename: Percival
authors.initials: P
authors.lastname: Sampaio-Barros
authors.forename: Anabela
authors.initials: A
authors.lastname: Barcelos
authors.forename: Bert
authors.initials: B
authors.lastname: Vander Cruyssen
authors.forename: Janitzia
authors.initials: J
authors.lastname: Vazquez-Mellado
authors.forename: Eduardo
authors.initials: E
authors.lastname: Collantes Estevez
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000208:ethnology* / Q000235:genetics* / Q000503:physiopathology; D001530:Belgium / Q000208:ethnology; D015897:Comorbidity; D004185:Disability Evaluation; D004359:Drug Therapy, Combination; D005260:Female; D020022:Genetic Predisposition to Disease; D015796:HLA-B27 Antigen / Q000235:genetics*; D006304:Health Status; D006801:Humans; D007843:Latin America / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012042:Registries; D012720:Severity of Illness Index; D013030:Spain / Q000208:ethnology; D013167:Spondylitis, Ankylosing / Q000208:ethnology* / Q000235:genetics* / Q000503:physiopathology; D011795:Surveys and Questionnaires
chemical_list: D018501:Antirheumatic Agents; D015796:HLA-B27 Antigen