Alnaimat Fatima, Al-Ghazawi Zaid, Shaf'ei Moayad, AbuHelal Ayman, Hamdan Omar, Barukba Hanan, Alalawneh Muath, Al-Ghazawi Mutasim A, Alawneh Khaldoon M
Department of Internal Medicine, Division of Rheumatology, School of Medicine, The University of Jordan, Amman, 11942, Jordan.
School of Medicine, University of Jordan, Amman, 11942, Jordan.
Clin Rheumatol. 2025 May 16. doi: 10.1007/s10067-025-07487-9.
BACKGROUND/AIM: Spondyloarthritis (SpA) is a group of chronic inflammatory rheumatic diseases with various subtypes. Given the limited research on SpA demographics and characteristics in the region, this study aims to provide insight into SpA in Jordan.
A cross-sectional study of patients diagnosed with SpA according to the Assessment of SpondyloArthritis International Society (ASAS) criteria who attended rheumatology clinics at two tertiary care centers between January and September 2023. Data on clinical, laboratory, and imaging findings were collected, and the prevalence of fibromyalgia was assessed using the FiRST tool.
Among 155 patients, 51% were male, with a mean age of 43.8 ± 12.7 years and a disease duration of 8.12 ± 8.7 years. The diagnostic delay averaged 4.49 ± 5.6 years. Ankylosing spondylitis was diagnosed in 43.2%, non-radiographic axial SpA in 7.7%, and psoriatic arthritis in 58%. Six patients (3.9%) had undergone hip replacement. Fibromyalgia was present in 25.3%, significantly linked to enthesitis (P < 0.001). Biological DMARDs (B-DMARDs) were used by 68.4% of patients, and conventional synthetic DMARDs (Cs-DMARDs) by 46.5%. Males were more likely to have elevated CRP levels (P = 0.041), while females had a higher prevalence of enthesitis (P = 0.013) and were more likely to use CS-DMARDs (P = 0.001).
SpA was associated with gender differences, with males having higher CRP levels and females experiencing more enthesitis and greater Cs-DMARD use. Diagnostic delay remains an issue and may have contributed to disease progression, leading to hip replacement in some patients. Further research is necessary to elucidate these distinctions more precisely.
背景/目的:脊柱关节炎(SpA)是一组具有多种亚型的慢性炎症性风湿性疾病。鉴于该地区对SpA人口统计学和特征的研究有限,本研究旨在深入了解约旦的SpA情况。
一项横断面研究,研究对象为2023年1月至9月期间在两家三级医疗中心的风湿病诊所就诊、根据国际脊柱关节炎评估协会(ASAS)标准诊断为SpA的患者。收集临床、实验室和影像学检查结果的数据,并使用FiRST工具评估纤维肌痛的患病率。
155例患者中,51%为男性,平均年龄43.8±12.7岁,病程8.12±8.7年。诊断延迟平均为4.49±5.6年。强直性脊柱炎诊断率为43.2%,非放射学轴向SpA为7.7%,银屑病关节炎为58%。6例患者(3.9%)接受了髋关节置换术。纤维肌痛的患病率为25.3%,与附着点炎显著相关(P<0.001)。68.4%的患者使用生物性改善病情抗风湿药(B-DMARDs),46.5%的患者使用传统合成改善病情抗风湿药(Cs-DMARDs)。男性更易出现C反应蛋白(CRP)水平升高(P=0.041),而女性附着点炎患病率更高(P=0.013),且更易使用Cs-DMARDs(P=0.001)。
SpA存在性别差异,男性CRP水平较高,女性附着点炎更多且使用Cs-DMARDs更多。诊断延迟仍是一个问题,可能导致疾病进展,致使部分患者接受髋关节置换术。有必要进一步开展研究以更精确地阐明这些差异。