Demographic and clinical characteristics of spondyloarthritis patients in Jordan: A cross-sectional study

Abstract

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.

Methods: 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.

Results: 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).

Conclusion: 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.

Keywords: Ankylosing spondylitis; Cross sectional study; Epidemiology; Psoriatic arthritis; Spondylarthritis.