Prevalence of extra-articular manifestations in patients with ankylosing spondylitis: a systematic review and meta-analysis

Abstract

ObjectivesUveitis, psoriasis and inflammatory bowel disease (IBD) are common extra-articular manifestations (EAM) in patients with ankylosing spondylitis (AS); however, summary data of reported prevalence are lacking. The aim of the present study was to summarise the prevalence of EAMs among patients with AS and to identify underlying factors to explain potential heterogeneity of prevalence.MethodsA systematic literature search was performed (Medline, Embase and Cochrane Library) to identify relevant articles. Risk of bias was assessed and data were extracted. Pooled prevalences were calculated. Potential sources of any observed clinical or methodological heterogeneity in the estimates were explored by subgroup and metaregression analysis.ResultsIn the 156 selected articles, 143 reported the prevalence of uveitis (44 372 patients), 56 of psoriasis (27 626 patients) and 69 of IBD (30 410 patients). Substantial heterogeneity was observed in prevalence estimates among all EAMs (I2=84–95%). The pooled prevalence of uveitis was 25.8% (95% CI 24.1% to 27.6%), and was positively associated in multivariable metaregression with disease duration (β 0.05, 95% CI 0.03 to 0.08) and random selection of patients (β −0.24, 95% CI −0.43 to −0.04). The pooled prevalence of psoriasis was 9.3% (95% CI 8.1% to 10.6%). The pooled prevalence of IBD was 6.8% (95% CI 6.1% to 7.7%) and was positively associated with the percentage of women in the studies (β 0.02, 95% CI 0.00 to 0.03). Geographical area was associated in multivariable metaregressions with prevalence of all EAMs.ConclusionsEAMs are common in patients with AS. The large heterogeneity between studies can be partly explained by differences in clinical as well as methodological characteristics.

Epidemiology of Traumatic Brain Injury in Europe: A Living Systematic Review

“…19,20 The following domains of bias or quality are assessed with the MORE checklist: funding of study, conflict of interest, study design, sampling, definition of cases, source of data, and reliability of estimates. Each domain was judged according to specific criteria and scored as ''OK, Minor Flaw, Major Flaw, and Poor reporting'' (Appendix 2) No studies were excluded from the review based on methodological quality.…”

The Frequency and Severity of Extraskeletal Manifestations of Ankylosing Spondylitis

“…[22], анализируя данные 156 источни-ков, демонстрируют развитие при АС у 9,3% псориаза и у 6,8% -ВЗК, I. Essers и соавт. По нашим данным, частота псориаза и ВЗК среди больных АС составила соответственно 3,7 и 3,5%.…”

“…С одной стороны, их весьма оптимистично характеризуют как редкие и не влияющие на качество жизни и исход бо-лезни, с другой -как частые и серьезно ухудшающие про-гноз [20][21][22].…”

Ankylosing Spondylitis Patients with HLA-B*2704 have More Uveitis than Patients with HLA-B*2705 in a North Chinese Population

“…It has been found in 5.3-33.2% of HLA-B27-positive AS patients across different racial groups. 12 It has already been proven that occurrence of uveitis is higher in HLA-B27-positive AS patients compared with those negative for HLA-B27. However, as to the relationship between subtypes of HLA-B27 and uveitis, the results are conflicting.…”