TY - JOUR T1 - Ethnic Influence in Clinical and Functional Measures of Brazilian Patients with Spondyloarthritis JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.110372 SP - jrheum.110372 AU - Thelma L. Skare AU - Adriana B. Bortoluzzo AU - Célio R. Gonçalves AU - José Antonio Braga da Silva AU - Antonio Carlos Ximenes AU - Manoel B. Bértolo AU - Sandra L.E. Ribeiro AU - Mauro Keiserman AU - Rita Menin AU - Sueli Carneiro AU - Valderílio F. Azevedo AU - Walber P. Vieira AU - Elisa N. Albuquerque AU - Washington A. Bianchi AU - Rubens Bonfiglioli AU - Cristiano Campanholo AU - Hellen M.S. Carvalho AU - Izaias P. Costa AU - Angela P. Duarte AU - Maria Bernadete O. Gavi AU - Charles L. Kohem AU - Nocy H. Leite AU - Sonia A.L. Lima AU - Eduardo S. Meirelles AU - Ivânio A. Pereira AU - Marcelo M. Pinheiro AU - Elizandra Polito AU - Gustavo G. Resende AU - Francisco Airton C. Rocha AU - Mittermayer B. Santiago AU - Maria de Fátima L.C. Sauma AU - Percival D. Sampaio-Barros Y1 - 2011/11/01 UR - http://www.jrheum.org/content/early/2011/10/28/jrheum.110372.abstract N2 - Objective Spondyloarthritides (SpA) can present different disease spectra according to ethnic background. The Brazilian Registry of Spondyloarthritis (RBE) is a nationwide registry that comprises a large databank on clinical, functional, and treatment data on Brazilian patients with SpA. The aim of our study was to analyze the influence of ethnic background in SpA disease patterns in a large series of Brazilian patients. Methods A common protocol of investigation was prospectively applied to 1318 SpA patients in 29 centers distributed through the main geographical regions in Brazil. The group comprised whites (65%), African Brazilians (31.3%), and people of mixed origins (3.7%). Clinical and demographic variables and various disease index scores were compiled. Ankylosing spondylitis (AS) was the most frequent disease in the group (65.1%); others were psoriatic arthritis (18.3%), undifferentiated SpA (6.8%), enteropathic arthritis (3.7%), and reactive arthritis (3.4%). Results White patients were significantly associated with psoriasis (p = 0.002), positive HLA-B27 (p = 0.014), and use of corticosteroids (p < 0.0001). Hip involvement (p = 0.02), axial inflammatory pain (p = 0.04), and radiographic sacroiliitis (p = 0.025) were associated with African Brazilian descent. Sex distribution, family history, and presence of peripheral arthritis, uveitis, dactylitis, urethritis, and inflammatory bowel disease were similar in the 3 groups, as well as age at disease onset, time from first symptom until diagnosis, and use of anti-tumor necrosis factor-α agents (p > 0.05). Schober test and thoracic expansion were similar in the 3 groups, whereas African Brazilians had higher Maastricht Ankylosing Spondylitis Enthesitis Scores (p = 0.005) and decreased lateral lumbar flexion (p = 0.003), while whites had a higher occiput-to-wall distance (p = 0.02). African Brazilians reported a worse patient global assessment of disease (p = 0.011). Other index scores and prevalence of work incapacity were similar in the 3 groups, although African Brazilians had worse performance in the Ankylosing Spondylitis Quality of Life questionnaire (p < 0.001). Conclusion Ethnic background is associated with distinct clinical aspects of SpA in Brazilian patients. African Brazilian patients with SpA have a poorer quality of life and report worse disease compared to whites. ER -