Abstract
We aimed to evaluate diagnosis delay and its impact on disease in terms of activity, functional disability, and radiographic damage in Moroccan patients with ankylosing spondylitis (AS). We recruited 100 Moroccan patients who fulfilled New York Classification criteria for AS. Diagnosis delay was defined as the interval between the first symptom of AS and the moment of a correct diagnosis. Disease activity was evaluated by the bath ankylosing spondylitis disease activity index (BASDAI), functional status by the bath ankylosing spondylitis functional index (BASFI), and radiographic damage by the bath ankylosing spondylitis radiologic index (BASRI). Measurements of spinal mobility were assessed. The average age at disease onset was 28.56 ± 10.9 years. Of the patients, 16% had juvenile-onset AS. Disease duration was 9.5 ± 6.8 years, and the average of diagnosis delay was 4.12 ± 3.99 years. There were no differences in diagnosis delay according to the age at onset, educational level, or the presence of extra-articular involvement. Our patients had altered functional ability. Patients with late diagnosis (>5 years) had statistically significant higher structural damage (BASRI) and severe limited spinal mobility. There was no correlation between diagnosis delay and the activity of disease. Few studies focused on diagnostic delay and its impact in patients with AS. It is necessary in our context to establish an early diagnosis taking into account the high frequency of severe functional disability in Moroccan AS.
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References
Dincer U, Cakar E, Kiralp MZ, Dursun H (2008) Diagnosis delay in patients with ankylosing spondylitis: possible reasons and proposals for new diagnostic criteria. Clin Rheumatol 27(4):457–462
Khan MA (2002) Ankylosing spondylitis: introductory comments on its diagnosis and treatment. Ann Rheum Dis 61(3):3–7
Davis JC, Dougados M, Braun J, Sieper J, van der Heijde D, van der Linden S (2006) Definition of disease duration in ankylosing spondylitis: reassessing the concept. Ann Rheum Dis 65(11):1518–1520
Van Den Bosch F, Kruithof E, Baeten D, Herssens A, de Keyser F, Het Mielants et al (2002) Randomized double-blind comparison of chimeric monoclonal antibody to tumor necrosis factor alpha (infliximab) versus placebo in active spondylarthropathy. Arthritis Rheum 46(3):755–765
Brandt J, Khariouzov A, Listing J, Haibel H, Sorensen H (2003) Grassnickel Letal. Six-month results of a double-blind, placebo-controlled trial of etanercept treatment in patients with active ankylosing spondylitis. Arthritis Rheum 48(6):1667–1675
Aggarwal R, Malaviya AN (2009) Diagnosis delay in patients with ankylosing spondylitis: factors and outcomes–an Indian perspective. Clin Rheumatol 28(3):327–331
El Mansouri L, Bahiri R, Abourazzak FZ, Abouqal R, Hajjaj-Hassouni N (2009) Two distinct patterns of ankylosing spondylitis in Moroccan patients. Rheumatol Int 29:1423–1429
Moll JM (1987) New criteria for the diagnosis of ankylosing spondylitis. Scand J Rheumatol Suppl 65:12–24
Rostom S, Benbouazza K, Amine B, Bahiri R, Lazrak N, Abouqal R, Guillemin F, Hajjaj-Hassouni N (2009) Psychometric evaluation of the Moroccan version of the Bath ankylosing spondylitis functional index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for use in patients with ankylosing spondylitis. Clin Rheumatol (in press)
Haywood KL, Garratt AM, Jordan K, Dziedzic K, Dawes PT (2004) Spinal mobility in ankylosing spondylitis: reliability, validity and responsiveness. Rheumatol 43:750–757
Kaya T, Gelal F, Gunaydin R (2006) The relationship between severity and extent of spinal involvement and spinal mobility and physical functioning in patients with ankylosing spondylitis. Clin Rheumatol 25:835–839
Dernis-Labous E, Messow M, Dougados M (2003) Assessment of fatigue in the management of patients with ankylosing spondylitis. Rheumatology 42:1523–1528
Kidd BL, Cawley MI (1988) Delay in diagnosis of spondarthritis. Br J Rheumatol 27(3):230–232
Feldtkeller E, Erlendsson J (2008) Definition of disease duration in ankylosing spondylitis. Rheumatol Int 28(7):693–696
Liao Z, Gu J, Huang F, Lin Z, Zhao L, Yu B (2009) Verification of Berlin algorithm for diagnosing undifferentiated spondyloarthropathy patients in Chinese population. Joint Bone Spine 76(2):146–149
Rudwaleit M, van der Heijde D, Khan MA et al (2004) How to diagnose axial spondyloarthropathies early. Ann Rheum Dis 63:535–543
Stone M, Warren RW, Bruckel J, Cooper D, Cortinovis D, Inman RD (2005) Juvenile-onset ankylosing spondylitis is associated with worse functional outcomes than adult-onset ankylosing spondylitis. Arthritis Rheum 53(3):445–451
Rudwaleit M, Listing J, Brandt J, Braun J, Sieper J (2004) Prediction of a major clinical response (BASDAI 50) to tumour necrosis factor alpha blockers in ankylosing spondylitis. Ann Rheum Dis 63(6):665–670
Gorman JD, SackK E, Davis JC Jr (2002) Treatment of ankylosing spondylitis by inhibition of tumor necrosis factor alpha. N Engl J Med 346(18):1349–1356
Ward MM, Reveille JD, Learch TJ, Davis JC Jr, Weisman MH (2008) Occupational physical activities and long-term functional and radiographic outcomes in patients with ankylosing spondylitis. Arthritis Rheum 59(6):822–832
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Ibn Yacoub, Y., Amine, B., Laatiris, A. et al. Relationship between diagnosis delay and disease features in Moroccan patients with ankylosing spondylitis. Rheumatol Int 32, 357–360 (2012). https://doi.org/10.1007/s00296-010-1635-7
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DOI: https://doi.org/10.1007/s00296-010-1635-7