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#414504 - 09/30/10 01:47 PM 50% w/ inflam back pain & HLAB27 have sacroiliitis
Sue22 Offline
Very_Addicted_to_AS_Kickin

Registered: 01/13/08
Posts: 21302
Loc: Upstate NY
thought this was interesting:

http://www.ncbi.nlm.nih.gov/pubmed/9433870

Quote:
CONCLUSION: With a calculated prevalence of 1.9%, spondylarthropathies are among the most frequent rheumatic diseases in the white population. HLA-B27 positive persons carry a 20-fold increased risk of developing SpA. AS and USpA are the most frequent SpA subtypes. Persons with IBP who are B27 positive have a 50% likelihood of having sacroiliitis.
_________________________

sue

Spondyloarthropathy, HLAB27 negative
Humira (still methylprednisone for flares, just not as often. Aleve if needed, rarely.)
LDN/zanaflex/flector patches over SI/ice
vits C, D. probiotics. hyaluronic acid. CoQ, Mg, Ca, K.
chiro
walk, bike
no dairy (casein sensitivity), limited eggs, limited yeast (bread)

Top
#414508 - 09/30/10 03:10 PM Re: 50% w/ inflam back pain & HLAB27 have sacroiliitis [Re: Sue22]
Inanna Offline
Very_Addicted_to_AS_Kickin

Registered: 11/15/01
Posts: 18056
Loc: UK
Very interesting. Thanks Sue. smile

Warm hugs,
_________________________
Kat

A life lived in fear is a life half lived.
"Strictly Ballroom"


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#414524 - 09/30/10 05:00 PM Re: 50% w/ inflam back pain & HLAB27 have sacroiliitis [Re: Sue22]
JamesB Offline
Presidential_AS_Kicker

Registered: 07/17/03
Posts: 2954
Loc: Northwest Ohio
I Sue,
Quote:
With a calculated prevalence of 1.9%, spondylarthropathies are among the most frequent rheumatic diseases in the white population.

This is interesting. I guess this means we are no longer considered rare birdies. eyelashes

Thanks for the link. I'll have a look shortly. Edit: Done smile



Edited by JamesB (09/30/10 05:00 PM)

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#414541 - 09/30/10 10:09 PM Re: 50% w/ inflam back pain & HLAB27 have sacroili [Re: Sue22]
Dow Offline
Imperial_AS_Kicker

Registered: 03/11/08
Posts: 3231
Loc: Valley Cottage, NY
also note that these conclusions are based on a test group of only 273 people

(and from 2005)

(and from Germany)
_________________________
Dow

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#414582 - 10/01/10 09:27 AM Re: 50% w/ inflam back pain & HLAB27 have sacroili [Re: Dow]
mig Offline


Registered: 04/27/02
Posts: 12454
Loc: ON, Canada
I think this info was published in 1998 and the 2005 date belongs to a comment on the study, made by Khan MA, titled: "Overestimation of the prevalence of ankylosing spondylitis in the Berlin study"

According to eMedicine, "Ankylosing Spondylitis and Undifferentiated Spondyloarthropathy" (updated May 2010)...

"Ankylosing spondylitis is the most prevalent of the classic spondyloarthropathies. Prevalence varies with the prevalence of the HLA-B27 gene, which increases with distance from the equator. Ankylosing spondylitis is more common in whites than in nonwhites. Prevalence is 0.1-1% of the general population,12,13,14 with the highest prevalence in northern European countries and the lowest in sub-Saharan Africa.5,15 Approximately 1-2% of all people who are positive for HLA-B27 develop ankylosing spondylitis. This increases to 15-20% if they have a first-degree relative with ankylosing spondylitis.16,4 Prevalence data for undifferentiated spondyloarthropathy are scarce, although this disorder appears to be at least as common as ankylosing spondylitis, if not more so.12 Its actual prevalence may be as high as 1-2% of the general population."


SpA's are not considered rare any more, but are still relatively unknown. Relative to RA, that is. smile

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#414585 - 10/01/10 09:57 AM Re: 50% w/ inflam back pain & HLAB27 have sacroili [Re: mig]
Stormy Offline
Black_Belt_AS_Kicker

Registered: 09/23/04
Posts: 430
I think it is important to note Dow's comment that this was based on a study of only 273 people.

Originally, 348 people were sent questionnaires; 273 responded. Of that number only 126 were selected for further evaluation based on symptoms reported. 90 persons agreed to participate and only 58 agreed to undergo MRI of the sacroiliac joints. The 50% figure came from those 58 carefully selected individuals.

Statistically, the study's conclusion that: "Persons with IBP who are B27 positive have a 50% likelihood of having sacroiliitis" is a stretch at best. Also keep in mind that while sacroiliitis is the hallmark of AS, AS is not the only cause of sacroiliitis.

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#414618 - 10/01/10 05:27 PM Re: 50% w/ inflam back pain & HLAB27 have sacroili [Re: Stormy]
Sue22 Offline
Very_Addicted_to_AS_Kickin

Registered: 01/13/08
Posts: 21302
Loc: Upstate NY
the issue i have with many clinical studies is the limited number of participants in the study.

found this paper when looking for this table:

Population or Disease Entity HLA-B27 –Positive
Healthy whites 8%
Healthy African Americans 4%
Ankylosing spondylitis (whites) 92%
Ankylosing spondylitis (African Americans) 50%
Reactive arthritis 60-80%
Psoriasis associated with spondylitis 60%
IBD associated with spondylitis 60%
Isolated acute anterior uveitis 50%
Undifferentiated spondyloarthropathy 20-25%

from: http://emedicine.medscape.com/article/332945-overview

i had originally set out to find the table that showed that while >90% of caucasians dx'ed with AS have the HLA-B27 gene, other spondys are considerably lower (psoriatic and IBD spondy ~60% each, undiff spondy only 20-25%).

and yes, SI dysfunction can be caused by other things, but think the point of this was simply saying if someone has IBP and B27 pos, then 50% chance of sacroiliitis, just trying to tie it all together. it really didn't say any more than that.

also if someone only has SI dysfunction, yes could be from more than one cause, but if someone has sacroiliitis plus spinal damage at a relatively young age, eye problems, skin problems, GI problems, and enthesitis in many joints around the body, especially all the "typical" spondy joints, or some combination of those things, its really about putting the whole story together.

this is just a piece of it. though i do wish clinical studies had larger sample sizes. but this is a start.
_________________________

sue

Spondyloarthropathy, HLAB27 negative
Humira (still methylprednisone for flares, just not as often. Aleve if needed, rarely.)
LDN/zanaflex/flector patches over SI/ice
vits C, D. probiotics. hyaluronic acid. CoQ, Mg, Ca, K.
chiro
walk, bike
no dairy (casein sensitivity), limited eggs, limited yeast (bread)

Top
#414619 - 10/01/10 05:39 PM Re: 50% w/ inflam back pain & HLAB27 have sacroili [Re: mig]
Sue22 Offline
Very_Addicted_to_AS_Kickin

Registered: 01/13/08
Posts: 21302
Loc: Upstate NY
[quote=mig
SpA's are not considered rare any more, but are still relatively unknown. Relative to RA, that is. smile [/quote]

from my experiences, that does seem to be a statement i can relate to.

my great grandmother was dx'ed with "rheumatism" and osteoporosis, she had kyphosis too later in life. my mother was dx'ed with "arthritis" but since nsaids largely worked for her, they never pressed further for a more exact dx.

and then there are my experiences and a number of others on here who took a long time to be dx'ed.

hopefully with new and better information, the time from onset of symptoms to dx and treatment will grow smaller.
_________________________

sue

Spondyloarthropathy, HLAB27 negative
Humira (still methylprednisone for flares, just not as often. Aleve if needed, rarely.)
LDN/zanaflex/flector patches over SI/ice
vits C, D. probiotics. hyaluronic acid. CoQ, Mg, Ca, K.
chiro
walk, bike
no dairy (casein sensitivity), limited eggs, limited yeast (bread)

Top

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