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further exploring the health status and functioning of Colombian patients with SpA. Equally important, we have demonstrated that there is no relationship between SpA and periodontitis. This finding may not necessarily have clinical implications will help in providing a better
understanding of the pathophysiology of SpA, since it contrasts with that of RA in terms of the importance of citrullination.
Still, we may face many challenges and unmet needs that will require to be addressed in order to
better understand the burden and the severity of SpA in Colombia and similarly in Latin America. National epidemiological studies including representative samples across the countries, may give better insight into the prevalence of SpA that of HLA-B27 in our population. The implementation
and validation of early referral strategies may improve the identification of patients in primary care. This type of interventions may help to reduce the time of delay of the diagnosis, which has not been estimated yet. With regard to evaluating the contribution of MRI to establishing a diagnosis, extensive training is warranted in collaboration with radiologists.
Future improvements of knowledge will lead to increased awareness and earlier diagnosis of SpA. Collaborative efforts aiming at promoting clinical and basic research in patients with SpA will
provide a platform that consolidates this area of research in Latin America. In this regard, the design and implementation of a registry for collecting information by a standardized protocol will contribute to this purpose.
In summary, in this thesis we have presented and discussed many topics in relation to the field of spondyloarthritis in Colombia. Definite progress has been made, but we have to keep moving so that our patients in Colombia will be better served.
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