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the ESSG or Amor-criteria. In contrast, in the DESIR22 cohort (patients with recent onset of inflammatory back pain) a higher sensitivity was found for the Amor and ESSG criteria (79 and 78%) as compared to ASAS criteria (70%).
The results of this study are also in line with previous Latin-American studies reporting a higher presence of peripheral manifestations in SpA (Latin-America 23 and Colombia 24,25,26). The high frequency of arthritis (72%) and enthesitis (57%) in our study are also in concordance with findings in Mexican mestizo 27 patients (peripheral arthritis in 66% and enthesitis in 47%) that had predominant involvement of lower limbs. Brazilian SpA-patients reported entheseal involvement in 54% 28. Similarly, in a study comparing the clinical expression of patients with AS between Latin- America and Europe 29 a higher frequency of peripheral arthritis (57% vs 42%) and enthesitis (54% vs 38%) was found in Latin-America. The GESPIC-Cohort 30 only reported peripheral arthritis being present in 14% of the AS patients and in 18% of the in non-radiographic axSpA. Similar findings were reported for enthesitis.
The frequency of HLA-B27 in our cohort was also rather low, not only in AS (63%) but also in SpA in general (44%), as compared to the frequency of HLA-B27 in AS patients in Europe and North America (80-90%) 31. This rather low frequency was similar to other studies in Latin America 32 and was similar to data recently reported in a Colombian study analyzing HLA-alleles33, finding a frequency of HLA-B27 of 40% in SpA patients. This may be explained by differences in the prevalence of HLA-B27 in the general population, which has a wide ethnic and geographic variation. However, studies assessing the frequency of HLA-B27 in Colombian patients with AS are lacking.
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