THU0610 The Spondyloarthritis in Sub-Saharan Africa in The Era of Asas Classification Criteria for Axial and Peripheral Spondyloarthritis

BackgroundThe ASAS classification criteria for axial and peripheral spondyloarthritis have revolutionized the management of patients with suspicion of spondyloarthritis (1,2). These criteria have not been validated in sub-Saharan Africans. Moreover, the application of these new criteria on a population of sub-Saharan Africa with spondyloarthritis has not yet been published.ObjectivesTo classify sub-Saharan Africans followed for spondyloarthritis according to the new ASAS classification criteria for axial spondyloarthritis and peripheral spondyloarthritis (1,2).MethodsWe performed a cross-sectional study among 6804 patients seen in the Rheumatology Unit of the Douala General Hospital, a tertiary healthcare centre in Cameroon, between January 2004 and December 2013. All patients followed for spondyloarthritis according to the Amor and/or ESSG criteria were collected to classify them according to the ASAS classification criteria for axial spondyloarthritis and peripheral spondyloarthritis.ResultsSeventy two (27 men and 45 women) patients fulfilled Amor and/or ESSG criteria. The mean age of these patients was 34 ± 13.9 years. The diagnosis was made primarily on the basis of clinical examination and X-rays of the spine and pelvis. No patient achieved a magnetic resonance imaging (MRI). The HLA B27 was negative in all patients tested. Ankylosing spondylitis was the most common spondyloarthritis, followed by reactive arthritis. The distribution of patients according to nosological entities and the predominant topography, axial and/or peripheral are respectively shown in Table 1 and Table 2. Two patients were not classified according to the ASAS criteria.Table 1, Distribution of patients according to disease entitiesn (%)Mean age ± SDSex (M/F)Ankylosing spondylitis36 (50.0)46±13.619/17Reactive arthritis29 (40.2)38±8.27/22Psoriatic arthritis3 (4.2)34±7.00/3Spondyloarthritis associated to inflammatory bowel diseases2 (2.8)32±3.81/1Undifferentiated spondyloarthritis2 (2.8)21±15.70/2Table 2.Distribution of patients according to ASAS classificationn (%)Mean age ± SDSex (M/F)Spondyloarthritis (all the patients)72 (100)36±13.927/45Axial Spondyloarthritis40 (55.5)39±12.611/29Peripheral Spondyloarthritis29 (40.3)34±16.714/15“Unclassified Spondyloarthritis” according to ASAS classification3 (4.2)27±11.51/1ConclusionsThe ASAS criteria have not changed the epidemiology of spondyloarthritis in Cameroon (prevalence 1.05%), and probably in all the sub-Saharan Africa. The diagnos