Axial Spondyloarthritis (axSpA) Global prevalence (%) of AS 7 Patients may experience additional disease-related manifestations 9,10 Prevalence Estimated prevalence of axSpA in adults aged is 0.70% * 8 18 to 44 years References: 1. van der Heijde D, et al. Ann Rheum Dis. 2017. pii: annrheumdis-2016-210770 2. Rudwaleit M, et al. Arthritis Rheum. 2005;52:1000–8 3. Sieper J, van der Heijde D. Arth Rheum. 2013;65:543–51 4. Poddubnyy D, et al. Ann Rheum Dis. 2011;70:1369–74 5. Sieper J, Rudwaleit M. Ann Rheum Dis. 2005;64:659–63 6. Sykes MP, et al. Rheumatology 2015;54:2283–4 7. Stolwijk C, et al. Arthritis Care Res. 2016;68:1320–31 8. Strand V, et al. Arthritis Care Res. 2013;65:1299–306 9. de Winter JJ, et al. Arthritis Res Ther. 2016;18:196 10. Davey-Ranasinghe N, Deodhar A. Curr Opin Rheumatol. 2013;25:509–16 11. Rudwaleit M, et al. Arthritis Rheum. 2006;54:569–78 12. Dougados M, et al. Clin Exp Rheumatol. 2017;35:209–13 13. Leverment S, et al. Rheumatol Int. 2017;37:257–71 *Based on a study conducted in the United States. Onset and diagnosis Affects young people: mean age of symptom onset 8.5 years to diagnosis 6 = in mid-20s. 5 Average delay of axSpA is a chronic inflammatory disease, predominantly involving the spine and sacroiliac joints. 1–4 Uveitis (eye inflammation) Osteoporosis and vertebral fractures (bone weakening and breakage or collapse of bones in the spine) Northern Arctic indigenous communities 0.35 Sub-Saharan Africa 0.02 Europe 0.25 North America 0.20 East Asia 0.16 South America 0.14 North Africa/Middle East 0.11 South-East Asia 0.07 South Asia 0.06 HQ/0417/CI/00039; Date of preparation: May 2017 spine sacroiliac joint Disease spectrum 2–4 Non-radiographic axSpA no definite sacroiliitis on X-ray; may have magnetic resonance imaging evidence of inflammation of sacroiliac joint Ankylosing spondylitis (AS) definite sacroiliitis on X-ray axSpA ~10–12% develop definite radiographic sacroiliitis over 2 years (without structural damage) (with structural damage) Symptoms 2,11–13 DISTURBED SLEEP because of back pain usually during the second half of the night REDUCED MOBILITY STIFFNESS FATIGUE INFLAMMATORY BACK PAIN (leading symptom) that improves with exercise, but not with rest (in contrast to mechanical back pain) Enthesitis (inflammation of the points of insertion of tendons and ligaments into bone; especially enthesitis of the heel) Psoriasis (skin disease) Inflammatory bowel disease (chronic inflammation of digestive tract) Peripheral arthritis (usually involving large joints)