Anti-Saccharomyces cerevisiae antibodies (ASCA) in spondyloarthritis: Prevalence and associated phenotype

ObjectiveThe aim of the study was to compare the prevalence of ASCA in spondyloarthrites (SpA) patients and to investigate the association between ASCA status and disease phenotype.MethodsWe performed a case-control study including SpA individuals fulfilling the ESSG SpA criteria. The following data were collected for analysis: gender, age, disease duration, clinical or associated features of SpA, treatments, HLAB27 and ASCA status. A control group of patients without SpA was also analyzed.ResultsA total of 235 patients with SpA and 54 control patients were studied. The median age of SpA patients (53.6% of male patients, 52.2% of HLAB27) was 46.0 [IQR 35.0-57.0] years old. Disease duration was 60.0 [IQR 24.0-156.0] months. Inflammatory bowel diseases were observed in 11% of SpA patients. ASCA positivity was significantly higher in SpA patients than in control patients (25.5% [95% CI 20.1-31.6] (IgG: 9.8%; IgA: 21.7%) vs. 7.4% [95% CI 2.1-17.9], P = 0.004). Multivariate analysis revealed that ASCA positivity was associated with peripheral involvement (OR: 3.30 [1.26-8.62], P = 0.015), presence of IBD (OR: 3.43 [1.15-10.20], P = 0.026), past of present history of uveitis (OR: 4.36 [1.08-17.64], P = 0.039) and arthritis (OR: 3.78 [1.57-9.15], P = 0.003).ConclusionOur results provided evidence that SpA patients had an increased prevalence of ASCA and that ASCA positivity might be associated with a particular phenotype, notably peripheral involvement and uveitis.