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high specificity18. In addition to sacroiliitis on radiographs, SI-MRI as well as HLAB27 serve as entry criteria in the ASAS classification criteria for axSpA. Additionally both tests (sacroiliitis by MRI and HLA-B27 positivity) have been included in the decision tree of the original and modified Berlin diagnostic algorithm and can be applied in clinical practice19.
Current situation regarding SpA in Colombia
Data in the literature reporting the behaviour of SpA in Colombia is limited and many efforts have been made to describe the landscape of this condition in the country. Just as in other countries in
Latin America, research about SpA is far less mature than research about other rheumatic disorders such as rheumatoid arthritis (RA) and systemic lupus erythematous20. The research in the field of
SpA performed in Colombia has been rather descriptive and based on clinical cohorts of patients in academic centers reporting disease manifestations, prognostic factors, biomarker levels and frequencies of HLA-B27.
Information from many studies performed in Colombia provide a preliminary impression with
regard to clinical presentation, main features and frequency of subtypes. One of the first analyses was the characterization, description of features by subtypes and the follow-up of 139 patients with SpA21. Male gender, the presence of uveitis and the early age of disease onset were associated
with a worse prognosis (more disease progression) of AS patients. In another study, increasing serum levels of biomarkers (IL-17, IL-23, IL-6, TNF-α, IL-1 α and CRP) were shown to be associated with poorer prognosis of patients with SpA22. Similarly, positive associations between enthesitis and IL-17 serum levels and between enthesitis and IL-23 synovial fluid levels were found in a small
sample of 62 patients23.
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