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THU0390 Clinical Characteristics of Spondyloarthritis in Japanese Patients
  1. C. Min1,
  2. K. Yoshida2,
  3. Y. Haji3,
  4. H. Inoue4,
  5. Y. Kaneko5,
  6. T. Kawasaki6,
  7. K. Matsui7,
  8. M. Morita8,
  9. K. Tada9,
  10. N. Takizawa10,
  11. N. Tamura9,
  12. N. Ichikawa11,
  13. Y. Taniguchi12,
  14. S. Tsuji13,
  15. M. Okada1,
  16. S. Kobayashi14,
  17. T. Tomita15,
  18. M. Kishimoto1
  1. 1Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo, Japan
  2. 2Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States
  3. 3Department of Rheumatology, Daido Hospital, Aichi
  4. 4Department of Orthopaedic Surgery, Juntendo University School of Medicine
  5. 5Department of Internal Medicine, Division of Rheumatology, Keio University School of Medicine, Tokyo
  6. 6Department of Orthopaedic Surgery, Shiga University of Medical Science, Shiga
  7. 7Department of Internal Medicine, Takikawa Municipal Hospital, Hokkaido
  8. 8Department of Orthopaedic Surgery, Fujita Health University, Aichi
  9. 9Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo
  10. 10Department of Rheumatology, Chubu Rosai Hospital, Aichi
  11. 11Institute of Rheumatology, Tokyo Women's Medical University, Tokyo
  12. 12Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi
  13. 13Department of Orthopaedics, Osaka Minami Medical Center, Osaka
  14. 14Department of Internal Medicine, Juntendo University Koshigaya Hospital, Saitama
  15. 15Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, Osaka, Japan

Abstract

Background Spondyloarthritis (SpA) has been considered relatively rare in Japan, with an estimated incidence rate of 0.48/100,000 person-years and an estimated population prevalence of less than 0.01%. However, in daily practice, we have diagnosed SpA more frequently after recent increase in awareness of this disease entity, suggesting presence of potentially severe under-diagnosis in the previous time periods. Further improvement of awareness of this disease entity is necessary to allow patients to receive appropriate treatments. In this study, we aim to characterize distinguishing clinical features of SpA in Japanese patients, which should then allow us to improve both under-diagnosis and misdiagnosis of this increasingly treatable disease entity.

Objectives To evaluate clinical characteristics commonly manifested in Japanese SpA patients in COMOSPA database.

Methods Descriptive statistics of patient demographics and clinical characteristics of SpA were provided in the Japanese subgroup comparing with those in rest of Asian countries and non-Asian countries. Prevalence of characteristics were compared across regions using ANOVA (continuous variables) or χ2 test (categorical variables) to identify clinical features that were more characteristic of Japanese SpA patients. These analyses were conducted using the COMOSPA database.

Results 161 Japanese patients, 933 non-Japanese Asian patients, and 2890 non-Asian patients were included in the study. Mean age and male percentage for Japanese patients were 48.9 years old and 59.3%, respectively. As a baseline characteristic, Japanese patients weighed less than other groups (65.0 vs. 66.6 vs. 78.3kg, p<0.001). Radiographic axial SpA patients were significantly fewer in Japanese patients (50.9 vs. 76.4 vs. 61.1%, p<0.001). Percentage of the patients with inflammatory back pain was lower in Japanese patients (71.9 vs. 88.6 vs. 85.1%, p<0.001) as well. In contrast, peripheral arthritis consistent with SpA was more common in Japanese patients (75.0 vs. 46.2 vs. 63.6%, p<0.001), as well as dactylitis (26.9 vs. 7.2 vs. 17.6%, p<0.001), enthesitis (48.1 vs. 23.5 vs. 42.1%, p<0.001) and nail involvements (25.5 vs. 3.3 vs. 13.5%, P<0.001). Psoriasis was also more common in Japanese patients (38.5 vs. 6.2 vs. 20.0%, p<0.001). HLA-B27 was less frequently positive in Japanese patients (29.2 vs. 80.0 vs. 49.9%, p<0.001). Functional status measured by BASFI (Bath Ankylosing Spondylitis Functional Index) and disease activity measured by BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) tended to be lower in Japanese patients compared to non-Asian patients.

Conclusions Japanese SpA patients demonstrated unique clinical pictures compared to other Asian and non-Asian countries. These results allow us to improve both under-diagnosis and misdiagnosis of the disease.

Disclosure of Interest C. Min Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, K. Yoshida Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, Y. Haji Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, H. Inoue Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, Y. Kaneko Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, T. Kawasaki Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, K. Matsui Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, M. Morita Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, K. Tada Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, N. Takizawa Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, N. Tamura Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, N. Ichikawa Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, Y. Taniguchi Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, S. Tsuji Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, M. Okada Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, S. Kobayashi Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, T. Tomita Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, M. Kishimoto Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None

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