title: Seronegative arthritis in South Asia: an up-to-date review.
abstract: This article summarises the available information on seronegative arthritides from South Asian countries, namely India, Pakistan, Bangladesh, Sri Lanka, Nepal, and Bhutan. The diseases described are spondyloarthritides (SpA), including ankylosing spondylitis (AS), psoriatic arthritis (PsA), reactive arthritis (ReA), inflammatory bowel disease-related arthritis (IBDa), enthesitis-related arthritis (ERA) of the paediatric age group, and undifferentiated spondyloarthritis (uSpA). Relevant information on SpA from South Asia is scarce. However, the available publications indicate that these are commonly seen conditions. HLA-B27 is present in approximately 6-8 % of the normal population in the Indian subcontinent. In the SpA group, HLA-B27 has the highest frequency in AS patients (>90 %) and the lowest in PsA patients. Clinical features are similar to those reported in standard textbooks, but with a few exceptions: e.g., in South Asian countries ERA is the most common subset of juvenile idiopathic arthritis (JIA), whereas in the West the most common subset of JIA is oligoarthritis. Poverty is a major challenge in treating these diseases in South Asia; with poor health insurance coverage, only a few patients are able to afford biological treatment. Therefore, rheumatologists have attempted novel treatment strategies for those with an unsatisfactory response to standard non-steroidal anti-inflammatory drugs (NSAIDs) or coxibs.
authors: Department of Rheumatology, Indian Spinal Injuries Centre Superspeciality Hospital, MM Road, Vasant Kunj, New Delhi, 110070, India, anand_malaviya@yahoo.com.
authors: Anand N
authors: AN
authors: Malaviya
authors: Sujata
authors: S
authors: Sawhney
authors: Narinder K
authors: NK
authors: Mehra
authors: Uma
authors: U
authors: Kanga
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use; D001211:Asia, Western / Q000453:epidemiology; D020022:Genetic Predisposition to Disease; D015796:HLA-B27 Antigen / Q000235:genetics; D006801:Humans; D000091402:Prohibitins; D025241:Spondylarthritis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000235:genetics
chemical_list: D018501:Antirheumatic Agents; D015796:HLA-B27 Antigen; C000717331:PHB2 protein, human; D000091402:Prohibitins