¹Djebbari Abderazak

¹HMRUC

Backgrond(s):  Spondyloarthritis (axSpA) is chronic inflammatory disease. Delay Diagnostic in   (axSpA) was  reported a decade ago to be between five and ten years. The objective of this study was to explore if the diagnostic delay has improved over the past years and to analyse factors associated with the delay.

Method(s): A rétrospective  cohort of Algerian axSpA stratified by age and sex was performed. Data from patient record had allowed to collect  demographic, disease-related, socioeconomic characteristics and Disease-related parameters comprised the date of first symptoms, the date of diagnosis, the HLA-B27 status as well as the presence of extra-articular manifestations (uveitis, psoriasis, chronic-inflammatory bowel disease). Multivariable linear regression analysis was used to analyse factors associated with the diagnostic delay.

Result(s): A total of 98 patient with axSpA were included in the analysis. The mean age was 58 years and 36.7% were female. The mean (95% confidence interval [CI]) diagnostic delay in the whole group was 5.7 (3.6– 6.8) years and the median was 2.8 years . Overall, 43 persons were diagnosed between  and 2005-2012 and 55 persons between 2012and 2020. The diagnostic delay was not substantially different in both periods:  For patients diagnosed between 2005-2012, the mean (95% CI) diagnostic delay was 5.9(4.1– 6.7) years and the median was 2.7 years. For patients diagnosed between 2012-2020, the mean (95% CI) diagnostic delay was 5.1(4.2– 8.1) years and the median was 2.7 years. axSpA with a long diagnostic delay were more often men, had less often a positive HLA-B27, more enthesitis and low educational level  compared to persons with a short diagnostic delay. Multivariable linear regression revealed that negative HLA-B27 status, enthesitis and younger age at symptom onset are factors associated with a longer diagnostic delay.

Conclusion(s): In Algeria, The mean diagnostic delay of about 6 years represents currently one of the major challenges in field of SpA. Men with negative HLA-B27 status, enthesitis and younger age at symptom onset had a negative impact on the diagnostic delay.