Page 26 - SPONDYLOARTHRITIS IN COLOMBIA -

ABSTRACT
Objective: To investigate the performance of classification criteria sets (ASAS, ESSG, and Amor) for spondyloarthritis (SpA) in a clinical practice cohort in Colombia, and provide insight into how rheumatologists follow the diagnostic path in patients suspected of SpA.
Methods: Patients with a rheumatologist’s diagnosis of SpA were retrospectively classified according to three criteria sets. Classification rate was defined as the proportion of patients fulfilling a particular criterion. Characteristics of patients fulfilling and not fulfilling each criteria were compared.
Results: The ASAS criteria classified 81% of all patients (n=581) as having either axial-SpA (44%) or peripheral-SpA (37%), whereas a lower proportion met ESSG-criteria (74%) and Amor-criteria (53%). There was a high degree of overlap among the different criteria, and 42% of the patients met all three criteria. Patients fulfilling all three criteria sets were older (36 vs. 30 years), had more SpA-features (3 vs. 1 features) and more frequently had a current or past history of back pain (77% vs. 43%), inflammatory back pain (47% vs. 13%), enthesitis (67% vs. 26%) and buttock pain (37% vs. 13%) vs those not fulfilling any criteria. HLA-B27, radiographs and MRI-SI were performed in 77%, 59% and 24% of the patients respectively.
Conclusion: The ASAS criteria classified more patients as having SpA in this Colombian cohort when the rheumatologist’s diagnosis is used as an external standard. Although physicians do not perform HLA-B27 or imaging in all patients, they do require these tests if the clinical symptoms fall short of confirming SpA and suspicion remains.
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