[Early referral of first line patients suspected of axial spondyloarthritis: the Belgian results of the RADAR study].
Currently, there is a 5 to 7 years gap between the first symptoms and the diagnosis of ankylosing spondylitis. A better patient referral might reduce this gap and accelerate the adequate treatment implementation. The study objective was to compare 2 referral strategies used in first line. In Belgium, 208 referral physicians assigned to 16 rheumatology centres were randomized to refer chronic back pain patients (with onset <45 years) using 1 of the 2 referral strategies: Strategy 1 :1 of 3 criteria (inflammatory back pain, HLA-B27, sacroiliitis on imaging); or Strategy 2: 2 of6 criteria (IBP inflammatory back pain, HLA-B27, sacroiliitis, family history, good response to NSAIDs, extra-articular manifestations). Among the 141 referred patients with strategy 1 and 2, 26.0 and 36.9% respectively were diagnosed with Axial Spondylarthritis (SpA). Inflammatory back pain, sacroiliitis and good respond to NSAIDs were the most frequently used criteria (92.9 %, 36.2 % and 33.3% respectively). This study emphasizes the high prevalence of undiagnosed axial SpA in patients with chronic back pain and stressed the necessity to increase awareness of the disease.
Service de Rhumatologie, CHU Brugmann, Bruxelles, Belgique. Jacques.BENTIN@chu-brugmann.be
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Bentin
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Van Praet
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Malaise
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François
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Mielants
D000328:Adult; D001416:Back Pain / Q000209:etiology*; D001530:Belgium; D059350:Chronic Pain / Q000209:etiology; D015796:HLA-B27 Antigen; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012017:Referral and Consultation; D025241:Spondylarthritis / Q000175:diagnosis*; D013167:Spondylitis, Ankylosing / Q000175:diagnosis*; D013997:Time Factors
D015796:HLA-B27 Antigen