Comparison in clinical features and life impact between juvenile-onset and adult-onset ankylosing spondylitis

Abstract

BACKGROUND/AIM: To compare the differences in clinical characteristics and disease impact on life between patients with juvenile-onset ankylosing spondylitis (JoAS) and patients with adult-onset AS (AoAS). MATERIALS AND METHODS: Demographic and clinical data were collected from 139 AS patients. Disease activity was defined with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Functional status was assessed with the Bath Ankylosing Spondylitis Functional Index (BASFI). Status of quality of life was evaluated with the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire. RESULTS: There were 50 patients with JoAS (36.0%) and 89 with AoAS (64.0%). The JoAS group showed more onset with peripheral joints involvement (P < 0.001), significant diagnosis delay (P < 0.001), worse functional status (P = 0.002), and poorer quality of life (P = 0.002). Patients with JoAS also showed a significantly lower rate in college education (P = 0.037) and marriage (P = 0.013). The rate of employment in the JoAS group was lower than that in the AoAS group. Although the difference in employment did not reach a significant level, the JoAS group included more patients who had not been employed since reaching adulthood (P = 0.015). CONCLUSION: Compared to patients with AoAS, patients with JoAS may need more specific clinical interventions as well as social assistance.