Perfil epidemiológico da espondiloartrite de início juvenil comparada com a espondiloartrite de início na vida adulta em uma grande coorte brasileira

Abstract

Objective: To analyze the clinical and epidemiologic characteristics ofjuvenile-onset spondyloarthritis (SpA) (<16 years) and compare them with a group of adult-onset (> 16 years) SpA patients. Patients and methods: Prospective, observational and multicentric cohort with 1,424 patients with the diagnosis of SpA according to the European Spondyloarthropathy Study Group (ESSG) submitted to a common protocol of investigation and recruited in 29 reference centers participants of the Brazilian Registry of Spondyloarthritis (RBE - Registro Brasileiro de Espondiloartrites). Patients were divided in two groups: age at onset < 16 years (JOSpA group) and age at onset 16 years (A0SpA group). Results: Among the 1,424 patients, 235 presented disease onset before 16 years (16.5%). The clinical and epidemiologic variables associated with JOSpA were male gender (p <0.001), lower limb arthritis (p = 0.001), enthesitis (p = 0.008), anterior uveitis (p = 0.041) and positive HLA-B27 (p = 0.017), associated with lower scores of disease activity (Bath Ankylosing Spondylitis Disease Activity Index - BASDAI; p = 0.007) and functionality (Bath Ankylosing Spondylitis Functional Index - BASFI; p = 0.036). Cutaneous psoriasis (p <0.001), inflammatory bowel disease (p = 0.023), dactylitis (p = 0.024) and nail involvement (p = 0.004) were more frequent in patients with adult-onset SpA. Conclusions: Patients with JOSpA in this large Brazilian cohort were characterized predominantly by male gender, peripheral involvement (arthritis and enthesitis), positive HLA-B27 and lower disease scores.