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ankylosing spondylitis (AS)

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Ankylosing spondylitis is one of a group of inflammatory rheumatic diseases known as spondylarthropathies - these diseases are characterised by predominant involvement of axial and peripheral joints and entheses (areas where tendons, ligaments or joint capsules attach to bone).

  • ankylosing spondylitis is a common seronegative spondylitis typically affecting the spine and sacroiliac joints
    • the prevalence amongst white males has been stated as about 0.5%
      • however NICE state that prevalence of 'clinically significant ankylosing spondylitis' is about 0.15%
        • annual incidence is 6.9 per 100,000 in the UK
    • male Caucasians are affected more severely and more often (3:1) than females. The mean age of onset is between 26 years of age
    • prevalence of ankylosing spondylitis in a population mirrors the frequency of the associated HLA-B27
      • aetiology of ankylosing spondylitis probably has a genetic component as 90% of Caucasians with the disease have the human leucocyte antigen HLA-B27, compared with around 10% of the general population of North and Central Europe
    • the disease is highly debilitating and can reduce quality of life as a result of stiffness, pain, fatigue, poor sleep, anxiety or the unwanted effects of medication
    • reported unemployment rates are three times higher among people with ankylosing spondylitis than in the general population
      • about a third of people with ankylosing spondylitis may be unable to work altogether, with a further 15% reporting some changes to their working lives (2)
    • ankylosing spondylitis is associated with an increased risk of death: it is estimated that patients have a standardised mortality ratio of 1.5 or greater (2)
    • therapeutic intervention aims to reduce inflammation and, therefore, pain and stiffness; to alleviate systemic symptoms such as fatigue; and to slow or stop the long-term progression of the disease, particularly the progressive loss of spinal mobility caused by ankylosis of the spine

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