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AS in Blacks: More Severe than Whites, Latinos

Clin Rheumatol; 2017 Oct; Jamalyaria, et al

Blacks with ankylosing spondylitis (AS) have more severe disease compared to either whites or Latinos, according to a recent study. Researchers assessed 925 AS patients (57 blacks, 805 whites, 63 Latinos) enrolled in the longitudinal Prospective Study of Outcomes in AS (PSOAS) for functional impairment, disease activity, and radiographic severity. Comparisons of clinical characteristics and HLA-B27 frequency for each group were performed; in 2 multivariable regression models, researchers compared the baseline Bath Ankylosing Spondylitis Radiographic Index (BASRI) and modified Stokes Ankylosing Spondylitis Spine Score (mSASSS) by ethnicity. They found:

  • Blacks had greater functional impairment (median 62.5 vs 27.8 in whites and 38.1 in Latinos), higher disease activity (median 5.9 vs 3.5 in whites and 4.5 in Latinos), erythrocyte sedimentation rate (median 27.0 in blacks vs 10.0 in whites and 17.0 in Latinos), and C-reactive protein levels (median 1.2 vs 0.4 mg/dL in whites and 0.9 in Latinos).
  • Baseline BASRI and mSASSS were higher in blacks (mean 9.5 and median 38.2, respectively) compared to whites (7.3 and 6.4) and Latinos (7.3 and 8.1), respectively, more significant as disease duration increased.

Jamalyaria F, Ward MW, Assassi S, et al. Ethnicity and disease severity in ankylosing spondylitis a cross-sectional analysis of three ethnic groups. Clin Rheumatol. 2017;36(10):2359-2364. doi:10.1007/s10067-017-3767-6.

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