Clinical, functional, and radiographic differences among juvenile-onset, adult-onset, and late-onset ankylosing spondylitis

Hung An Chen, Chun Hsiung Chen, Hsien Tzung Liao, Yeong Jang Lin, Pei Chih Chen, Wei Sheng Chen, Chih Chiang Chien, Chung Tei Chou

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Objective: The aim of our study was to compare the clinical, functional, and radiographic outcomes at different ages of onset in patients with ankylosing spondylitis (AS). Methods: A total of 546 patients were enrolled consecutively and classified into 3 groups based on their age at symptom onset: (1) juvenile-onset AS (age ≤ 16 years; JoAS); (2) adult-onset AS (> 16 but <40 years; AoAS); and (3) late-onset AS (≥ 40 years; LoAS). We compared the differences among the 3 groups. OR for disease outcomes were calculated and adjusted for sex, HLA-B27, and disease duration. Results: There were 67 patients (12.3%) with JoAS, 460 (84.2%) with AoAS, and 19 (3.5%) with LoAS. Male sex and HLA-B27 were associated with a younger age at onset (p <0.001). Compared to patients with AoAS, patients with JoAS were more likely to present with peripheral arthritis, while patients with JoAS and LoAS were less likely to have back pain at the onset of AS (p <0.05). After controlling for multiple covariates, JoAS was found to be associated with a worse functional outcome and global assessment, and a high serum immunoglobulin A level (p <0.05). Patients with JoAS had less lumbar spinal radiographic severity (p <0.05). There were no statistical differences in clinical or functional outcome between the LoAS and AoAS groups. None of the LoAS patients had radiographic hip involvement. Conclusion: Sex and HLA-B27 are significantly associated with age at onset of AS. Both JoAS and LoAS have their distinctive symptoms/signs at onset and different disease outcomes.

Original languageEnglish
Pages (from-to)1013-1018
Number of pages6
JournalJournal of Rheumatology
Volume39
Issue number5
DOIs
Publication statusPublished - May 2012

Fingerprint

Ankylosing Spondylitis
Age of Onset
HLA-B27 Antigen
Back Pain
Immunoglobulin A
Signs and Symptoms
Arthritis
Hip
Outcome Assessment (Health Care)
Serum

Keywords

  • Ankylosing spondylitis
  • Onset age
  • Outcome

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy

Cite this

Chen, H. A., Chen, C. H., Liao, H. T., Lin, Y. J., Chen, P. C., Chen, W. S., ... Chou, C. T. (2012). Clinical, functional, and radiographic differences among juvenile-onset, adult-onset, and late-onset ankylosing spondylitis. Journal of Rheumatology, 39(5), 1013-1018. https://doi.org/10.3899/jrheum.111031

Clinical, functional, and radiographic differences among juvenile-onset, adult-onset, and late-onset ankylosing spondylitis. / Chen, Hung An; Chen, Chun Hsiung; Liao, Hsien Tzung; Lin, Yeong Jang; Chen, Pei Chih; Chen, Wei Sheng; Chien, Chih Chiang; Chou, Chung Tei.

In: Journal of Rheumatology, Vol. 39, No. 5, 05.2012, p. 1013-1018.

Research output: Contribution to journalArticle

Chen, HA, Chen, CH, Liao, HT, Lin, YJ, Chen, PC, Chen, WS, Chien, CC & Chou, CT 2012, 'Clinical, functional, and radiographic differences among juvenile-onset, adult-onset, and late-onset ankylosing spondylitis', Journal of Rheumatology, vol. 39, no. 5, pp. 1013-1018. https://doi.org/10.3899/jrheum.111031
Chen, Hung An ; Chen, Chun Hsiung ; Liao, Hsien Tzung ; Lin, Yeong Jang ; Chen, Pei Chih ; Chen, Wei Sheng ; Chien, Chih Chiang ; Chou, Chung Tei. / Clinical, functional, and radiographic differences among juvenile-onset, adult-onset, and late-onset ankylosing spondylitis. In: Journal of Rheumatology. 2012 ; Vol. 39, No. 5. pp. 1013-1018.
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abstract = "Objective: The aim of our study was to compare the clinical, functional, and radiographic outcomes at different ages of onset in patients with ankylosing spondylitis (AS). Methods: A total of 546 patients were enrolled consecutively and classified into 3 groups based on their age at symptom onset: (1) juvenile-onset AS (age ≤ 16 years; JoAS); (2) adult-onset AS (> 16 but <40 years; AoAS); and (3) late-onset AS (≥ 40 years; LoAS). We compared the differences among the 3 groups. OR for disease outcomes were calculated and adjusted for sex, HLA-B27, and disease duration. Results: There were 67 patients (12.3{\%}) with JoAS, 460 (84.2{\%}) with AoAS, and 19 (3.5{\%}) with LoAS. Male sex and HLA-B27 were associated with a younger age at onset (p <0.001). Compared to patients with AoAS, patients with JoAS were more likely to present with peripheral arthritis, while patients with JoAS and LoAS were less likely to have back pain at the onset of AS (p <0.05). After controlling for multiple covariates, JoAS was found to be associated with a worse functional outcome and global assessment, and a high serum immunoglobulin A level (p <0.05). Patients with JoAS had less lumbar spinal radiographic severity (p <0.05). There were no statistical differences in clinical or functional outcome between the LoAS and AoAS groups. None of the LoAS patients had radiographic hip involvement. Conclusion: Sex and HLA-B27 are significantly associated with age at onset of AS. Both JoAS and LoAS have their distinctive symptoms/signs at onset and different disease outcomes.",
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AU - Chen, Chun Hsiung

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AU - Lin, Yeong Jang

AU - Chen, Pei Chih

AU - Chen, Wei Sheng

AU - Chien, Chih Chiang

AU - Chou, Chung Tei

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AB - Objective: The aim of our study was to compare the clinical, functional, and radiographic outcomes at different ages of onset in patients with ankylosing spondylitis (AS). Methods: A total of 546 patients were enrolled consecutively and classified into 3 groups based on their age at symptom onset: (1) juvenile-onset AS (age ≤ 16 years; JoAS); (2) adult-onset AS (> 16 but <40 years; AoAS); and (3) late-onset AS (≥ 40 years; LoAS). We compared the differences among the 3 groups. OR for disease outcomes were calculated and adjusted for sex, HLA-B27, and disease duration. Results: There were 67 patients (12.3%) with JoAS, 460 (84.2%) with AoAS, and 19 (3.5%) with LoAS. Male sex and HLA-B27 were associated with a younger age at onset (p <0.001). Compared to patients with AoAS, patients with JoAS were more likely to present with peripheral arthritis, while patients with JoAS and LoAS were less likely to have back pain at the onset of AS (p <0.05). After controlling for multiple covariates, JoAS was found to be associated with a worse functional outcome and global assessment, and a high serum immunoglobulin A level (p <0.05). Patients with JoAS had less lumbar spinal radiographic severity (p <0.05). There were no statistical differences in clinical or functional outcome between the LoAS and AoAS groups. None of the LoAS patients had radiographic hip involvement. Conclusion: Sex and HLA-B27 are significantly associated with age at onset of AS. Both JoAS and LoAS have their distinctive symptoms/signs at onset and different disease outcomes.

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KW - Onset age

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