ABS0142 THE CHALLENGES OF ASAS CRITERIA IN REAL-WORLD PATIENTS WITH SpA IN COLOMBIA MUST BE ADDRESSED

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Background: The Assessment of Spondyloarthritis International Society (ASAS) criteria are the globally recognized standard for classifying Spondyloarthritis (SpA). However, it is important to note that less than 6% of the sample used in the development and validation of these criteria included Latin American populations, highlighting a significant gap that must be addressed. Objectives: This study aims to present a large Colombian cohort of patients with SpA, describe their characteristics and compare the ASAS criteria with rheumatologist criteria. Methods: This cohort was collected in three referral institutions in Colombia between 1990 and 2015. At least one of three SpA expert rheumatologists evaluated patients with suspicious SpA in the outpatient clinic or hospitalization. At the time of diagnosis of SpA, a structured survey was performed in patients with SpA. Patients with SpA were classified according to modified New York criteria (mNY), The European Spondyloarthropathy Study Group criteria (ESSG), and ASAS criteria. The measures of central tendency and dispersion were done on continuing variables. Absolute and relative frequency calculations were made for the qualitative variables. The chi-square test was chosen for qualitative variables, and the mean difference for quantitative variables. Results: The GESPA cohort included 461 patients with SpA, primarily male (65.7%) and Hispanic (84.4%), and an onset of the disease before age 45 years in 89.4%. Back pain was the most reported symptom (82%), it is characterized by morning stiffness (80.4%), chronic pain (62.2%), and inflammatory back pain (IBP) in 41.5% of cases. Buttock pain was noted in 42.3%, dactylitis in 18%, uveitis in 9.5%, and psoriasis in 4.1%. Sacroiliitis was detected in 46.9% of X-rays and 22.1% of MRIs, with a 41% frequency of the HLA-B*27 allele. According to the ASAS criteria, the pSpA presentation was the most frequent (58.1%), followed by axSpA (32.8%) and unclassified patients (9.1%). The ASAS criteria had a sensitivity of 90.8% compared to the rheumatologist's criteria. Among 151 axSpA patients defined by ASAS, 113 patients (74.8%) and 102 patients (67.5%) were well classified as ankylosing spondylitis (AS) by mNY, and ESSG, respectively. The remaining percentage were misclassified by the mNY and ESSG classifications as non-AS because these classifications do not include the nr-axSpA. Among 268 pSpA patients defined by ASAS, 178 patients (66.4%) and 170 patients (63.4%) were well classified as non-AS by mNY, and ESSG, respectively. However, 90 patients (33.6%) and 98 patients (36.6%) were classified as AS by mNY and ESSG, respectively. However, ASAS classified them as pSpA because 100% did not meet the entry axSpA criteria (Figure 1). Conclusion: The GESPA cohort is composed mainly of young males and pSpA by ASAS criteria. The buttock pain is more frequent than peripheral symptoms of SpA. Sacroiliitis on imaging is present in less than half of patients. The prevalence of HLA-B*27 is lower than other international cohorts. The ASAS criteria have good sensitivity, but one-third of axSpA patients were misclassified as pSpA because they do not meet the entry axSpA criteria, but they are really ankylotic by other criteria. Figure 1Comparing between ASAS criteria and mNY or ESSG criteria. REFERENCES: NIL . Acknowledgements: Asociación colombiana de reumatología (ASOREUMA). Disclosure of Interests: None declared . © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

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