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Study: SpA may be underdiagnosed
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Demographic and methodologic characteristic differences may explain the large variations in reported spondyloarthritis prevalence rates.
In this first systemic literature review on the prevalence of spondyloarthritis (SpA), the researchers searched for original research studies that reported primary prevalence data on SpA or its subtypes, ankylosing spondylitis (AS), psoriatic arthritis (PsA), SpA related to inflammatory bowel disease (IBD-SpA), reactive arthritis (ReA) and undifferentiated SpA (uSpA). Their search window was between 1975 and 2014.
Using a standardized form, two researchers extracted data on study identification (ie, first author and year of publication) as well as demographic (ie, mean age, proportion of female patients, geographic area and setting) and methodologic characteristics. They divided geographic areas as follows: Europe; North America; South America; Middle East and North Africa; Sub-Saharan Africa; Central Asia and Russia; South Asia; Southeast Asia; East Asia; Oceania; and “Northern Arctic indigenous communities.”
The researchers calculated pooled prevalence from the 80 studies that met the inclusion criteria.
SpA is a common disease with a large variation in prevalence rates, the authors wrote. SpA pooled prevalence rates ranged from 0.20% in Southeast Asia to 1.61% in Northern Artic communities. For AS, prevalence rates went from 0.02% in Sub-Saharan Africa up to 0.35% in Northern Arctic communities. The prevalence of PsA was 0.01% in the Middle East and ranged to 0.19%) in Europe. There were too few studies on ReA, IBD-SpA and uSpA to conduct a meta-analysis.
Geographic area was one of the most important factors for the heterogeneity in SpA prevalence rates, according to the authors. In particular, genetic characteristics such as HLA-B27, which has a significant association with SpA, may be the cause. Other demographic and methodologic characteristics were also linked to heterogeneity, including the proportion of women, year of data collection and case finding.
These results may indicate that SpA is underdiagnosed; increased recognition of the disease will likely lead to increased prevalence, the authors wrote. — by Colleen Owens
Disclosure: The researchers report no relevant financial disclosures.
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