PREDICTIVE FACTORS OF SEVERITY OF SPONDYLOARTHROPATHY IN NORTH-AFRICA

Both genetic and environmental factors probably influence the severity of spondyloarthropathies. Hip involvement, which may be used as a mar ker of disease severity, is more frequent in spondyloarthropalhies dev eloped in North Africa. The objective of this study was to determine t he predisposing factors of hip involvement in spondyloarthropathy in N orth Africa. Patients fulfilled the Amor or European Spondyloarthropat hy Study Group (ESSG) criteria of spondyloarthropathy. The study was r etrospective, cross-sectional, multicentre and carried out in North Af rica. The data collected were demographic data, socio-cultural factors and clinical presentation at onset. The risk of hip involvement with regard to disease duration was estimated using Kaplan-Meier's method. The predictive value of each variable with regard to time to hip invol vement was evaluated using a uni- and then a multivariate Cox proporti onal hazard model. Five hundred and eighteen patients were included. T he risk of hip involvement was estimated at 39 +/- 3% after 10 yr dise ase duration. The factors picked up by the multivariate analysis were: diagnostic delay less than 7 yr, age at onset below 24 yr and a combi nation of lower social class' and 'no refrigerator at home'. This stud y confirms the high prevalence of hip involvement during the course of spondyloarthropathy in North Africa and suggests a role of environmen tal factors in its appearance.