Characteristics of late-onset spondyloarthritis in Japan: A retrospective cohort study. Issue 7 (February 2019)

• Record Type: Journal Article
• Authors: Endo, Yushiro; Fujikawa, Keita; Koga, Tomohiro; Mizokami, Akinari; Mine, Masanobu; Tsukada, Toshiaki; Uetani, Masataka; Kawakami, Atsushi
• Other Names: Hajji. Raouf section editor.
• Is Part Of: Medicine. Volume 98:Issue 7(2019)
• Publication Date: 2019-02
• Subjects: early-onset spondyloarthritis -- late-onset spondyloarthritis -- peripheral spondyloarthritis -- spondyloarthritis; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000014431
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: Spondyloarthritis may be increasingly present in older patients as life expectancy increases. We investigated clinical differences between early-onset and late-onset spondyloarthritis in Japan. We retrospectively reviewed 114 patients consecutively diagnosed with spondyloarthritis. The clinical course of each patient was observed for ≥1 year. We defined early-onset and late-onset spondyloarthritis as <57 or ≥57 years at a median age of this study group, respectively. We compared clinical characteristics between these 2 groups. Disease duration was significantly shorter before diagnosis in the late-onset group ( P < .01). Inflammatory back pain (IBP) was significantly more common in the early-onset group ( P < .01), whereas dactylitis frequency was significantly higher in the late-onset group. Significantly more patients with early-onset spondyloarthritis were human leukocyte antigen (HLA) B27-positive ( P < .01). Articular synovitis, particularly of the wrist, was significantly more common on power Doppler ultrasound (PDUS) in the late-onset group ( P < .01). Tenosynovitis or peritendinitis, particularly in the finger and wrist flexors were also more frequent in the late-onset group ( P < .001 and P < .05, respectively). Enthesitis of the finger collateral ligament and lateral collateral ligament were significantly more common in the late-onset group (both P < .05). Multiple logistic regression analysis revealed that, comparatively, IBP was significantly and independently much more likely to occur in the early-onset group. The patients with late-onset spondyloarthritis had a lower frequency of IBP and HLA B27 and a higher frequency of dactylitis and PDUS findings in peripheral involvement.