A high prevalence of comorbidities in SpA has been shown. Rigorous application of systematic evaluation of comorbidities may permit earlier detection, which may ultimately result in an improved outcome of patients with SpA.

A referral strategy based on three criteria leads to a diagnosis of axial SpA in approximately 35% of patients with CBP and is applicable across countries and geographical locales with presumably different levels of expertise in axial SpA.

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It was the purpose of this study to better define the frequency of HLA-B27 subtypes and HLA class II alleles among indigenous populations from the eastern tip of the Chukotka Peninsula of Siberia, Russia, which have higher frequencies of HLA-B27 (40%) and spondyloarthropathies (2%) than Caucasian populations and test the hypothesis that these populations are more closely related to Orientals. Siberian Eskimos and Chukchi residing in four coastal villages on the Chukotka Peninsula inhabited by Siberian Eskimos and Chukchi people were examined using oligotyping of the polymerase-chain reaction-amplified second and third exons of the HLA-B27 gene. HLA-class II alleles (DRB1, DQA1 and DQB1) were similarly determined. Of 88 HLA-B27 positive individuals from these villages, all had HLA-B*2705, including the four patients with Reiter's syndrome and the five ankylosing spondylitis, except one Eskimo control who had HLA-B*2702. None had HLA-B*2704, a frequent subtype in Orientals. HLA-class II typing in 70 Siberian Eskimos and 71 Siberian coastal Chukchi revealed HLA-DRB1*0401, DRB1*0802, *0901 and *1402 to account for nearly all the DRB1 alleles found in this population, similar to what has been described in Eskimos in Alaska, but different from Chinese or native Americans in the U.S. The overwhelming majority of the individuals examined had HLA-DQB1*0301, similar to what has been observed in Native Americans. The Siberian Eskimos differed from the coastal Chukchi only in the occurrence of HLA-DRB1*0701, DQA1*0201, DQB1*0201 alleles, which occurred only in the former group. These data suggest that the Chukotka population is genetically more closely related to Caucasians and native Americans and less to other Oriental populations.

Aim:The hip joint is the most commonly affected non-axial joint in ankylosing spondylitis (AS). Data on the effects of tumor necrosis factorα inhibitors (TNFi) in AS patients with coxitis are limited. The aim of this study was evaluation of coxitis treated with the TNFi golimumab in real-world settings.Methods: This study was a prospective non-interventional cohort study. A total of 39 patients newly prescribed with golimumab were enrolled and followed for up to 24 months. The data collected included BASFI, BASMI, ASDAS-CRP, BASDAI indices. BASRI-hip X-ray score was assessed at baseline, and at 12 and 24 months. Magnetic resonance imaging (MRI) and ultrasound examination data were obtained at baseline, and at 6 and 12 months.Results: Significant improvements in BASFI, BASMI, ASDAS-CRP, BASDAI scores were observed (P ≤ 0.0001), but the BASRI-hip score remained stable. After 6 months of treatment, MRI signs of joint effusion were found in a smaller percentage of patients compared with baseline (P = 0.005 for the right and P = 0.015 for the left hip joints). After 12 months, this percentage was significantly lower than at baseline for the right hip joint (P = 0.005) and numerically lower for the left hip joint (P = 0.098).Ultrasound showed a significant increase in the percentage of patients without inflammatory changes after 6 and 12 months compared with baseline (right hip joint: P = 0.026 and P = 0.045, respectively; left hip joint: P = 0.026 for both time points). Conclusion:Golimumab therapy in AS patients with coxitis was accompanied by improvement in clinical scores, and in MRI and ultrasound findings without obvious radiographic progress.