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Concepts and epidemiology of spondyloarthritis

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The term ‘spondyloarthritides’ (SpA) comprises ankylosing spondylitis (AS), reactive arthritis, arthritis/spondylitis with inflammatory bowel disease, and arthritis/spondylitis with psoriasis. The main links between these diseases are an association with HLA-B27 and a similar clinical picture. Patients normally present with chronic low back pain or asymmetrical arthritis, predominantly of the lower limbs, and an overlap of these symptoms often occurs. AS is regarded as the most severe subtype. Recent attention has focused on earlier diagnosis of AS among patients with chronic low back, and this is becoming more important as effective therapies for early treatment have become available. AS is a disease of young people, normally starting in the third decade of life. The incidence and prevalence rates of AS, and of SpA as a whole, are strongly dependent and are directly correlated to the prevalence of HLA-B27 in a given population. Incidence rates of 0.5–8.2/100 000 population and prevalence rates of 0.2–1.2% have been described for AS, and about double these figures have been reported for SpA.

Section snippets

Concepts of spondyloarthritides

More than 30 years ago, a group of rheumatic diseases, labelled the ‘spondyloarthritides’ (SpA), was separated from other rheumatic diseases because of many common features and clear differences from other arthritides such as rheumatoid arthritis.1 Recently, a consensus was reached that the term ‘spondyloarthritis’ is preferable to ‘spondyloarthropathy’ to emphasize the inflammatory nature of these diseases.2 SpA comprise ankylosing spondylitis (AS), reactive arthritis or Reiter's syndrome,

Incidence and prevalence of ankylosing spondylitis and other spondyloarthritides

The term ‘epidemiology’ in the traditional sense means the study of the distribution of a disease and the risk factors for its development. More broadly, this includes the scientific methods used to diagnose, analyse and prevent or control a health problem. This part of the article will concentrate on incidence and prevalence data for AS and the other SpA.

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