{
  "abstract": "Objectives: To characterise the phenotype, disease burden, comorbidities, patient-reported outcomes (PROs) and treatment patterns of axial spondyloarthritis (axSpA) across Arab countries and evaluate regional heterogeneity.\n\nMethods: Profile of Axial Spondyloarthritis in Arab Countries (PROSPA), a cross-sectional, multinational study by the ArLAR Research Group across 33 rheumatology centres in 15 countries, enrolled adults with axSpA during a routine visit. Standardised data on validated PROs, disease characteristics, comorbidities and treatment were collected. Patients were stratified by Arab subregion (North Africa, the Levant and the Gulf). Between-group comparisons used Welch analysis of variance, Kruskal-Wallis and χ2 tests. Mixed-effects modelling tested whether regional differences in Assessment of SpondyloArthritis international Society Health Index (ASAS-HI) remained independent after adjustment.\n\nResults: Of 1112 patients (mean age 42.6 years, median disease duration 10 years, 63.8% male), radiographic (r) predominated over non-radiographic (nr) axSpA (r/nr ratio 3.7). Peripheral arthritis occurred in 45.7%, coxitis in 31.7%, uveitis in 16.7% and psoriasis in 17.4%. Human leucocyte antigen B27 was positive in 51.5% of 615 tested. Disease activity was moderate to high; biologic disease-modifying antirheumatic drugs (bDMARDs) were used in 70.1%, 36.4% were people who smoke and 5.2% had a tuberculosis history. North Africa had the highest r/nr ratio, worst PROs and lowest bDMARD use, despite comparable disease activity. Regional differences in ASAS-HI did not persist after adjustment; disease activity and function accounted for most explained variance.\n\nConclusions: This largest multinational axSpA study revealed a predominantly radiographic phenotype, significant disease burden and a comorbidity profile marked by high smoking and tuberculosis rates. After adjustment, region was not independently associated with ASAS-HI; disease activity and function, rather than geography, explained most of the variance in health status.",
  "abstract_shown": true,
  "affiliations": [
    "Rheumatology, Saint Joseph University, Beirut, Lebanon",
    "Rheumatology, Hotel-Dieu de France Hospital, Beirut, Lebanon",
    "Saint George Hospital University Medical Center, Saint George University of Beirut, Beirut, Lebanon",
    "Épidémiologie Clinique et Toxicologie - Liban (INSPECT-LB), Institut National de Santé Publique, Beirut, Lebanon",
    "Rheumatology, Tunis El Manar University, Tunis, Tunisia",
    "Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia",
    "University of Kurdistan Hawler, Erbil, Iraq",
    "Saad Dahlab Blida University, Algiers, Algeria",
    "Douera University Hospital, Algiers, Algeria",
    "King Hamad University Hospital, Bahrain, Bahrain",
    "Emirates Health Services, Alkuwait Hospital-Dubai, Dubai, UAE",
    "Mohamed Lamine Debaghine University Hospital, Algiers, Algeria",
    "El Ayachi Hospital, Rabat, Morocco",
    "Rabat University Hospital, Rabat, Morocco",
    "University of Jordan, Amman, Jordan",
    "Faculty of Medicine of Tunis, Kassab Institute, Tunis, Tunisia",
    "Cairo University, Cairo, Egypt",
    "Issaad Hassani Beni Messous Hospital, Algiers, Algeria",
    "Suez Canal University, Ismailia, Egypt",
    "Asterclinics, Abu Dhabi, UAE",
    "Ibn-Alnafis Hospital, Damascus, Syrian Arab Republic",
    "Rabta Hospital, Tunis, Tunisia",
    "Rheumatology Unit, Department of Medicine, University of Baghdad, Baghdad, Iraq",
    "Faculty of Medicine of Tunis, Mongi Slim Hospital, Tunis, Tunisia",
    "Faculty of Medicine Mouloud Mammeri, Tizi Ouzou, Algeria",
    "Sousse University, Sousse, Tunisia",
    "Farhat Hached University Hospital, Sousse, Tunisia",
    "University of Bahri, Khartoum, Sudan",
    "Charles Nicolle Hospital, Tunis, Tunisia",
    "College of Medicine, Prince Sultan Military Medical City, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia",
    "Al Ahli Hospital, Hebron, Palestine",
    "Hopital Cochin, University Paris Cité, Paris, France",
    "International University of Rabat, Rabat, Morocco",
    "Hôpital Universitaire International de Rabat, Rabat, Morocco"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 40,
  "authors": [
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        7,
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      "name": "Fatma Zohra Yasmina Heddi"
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      "orcid": "0000-0001-8708-9324"
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      "name": "Sherif Gamal",
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      "name": "Salma Zemrani"
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      "name": "Selma Abdellaoui"
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        18,
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      "name": "Nesreen Mohamed Ismail Moustafa"
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        20
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      "name": "Nada Alchamaa"
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      "name": "Chafika Haouichet"
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      "name": "Safa Rahmouni"
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        9
      ],
      "name": "Noora Rashed Al Khater"
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    {
      "affs": [
        22
      ],
      "name": "Nizar Abdulateef Al-Ani"
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    {
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        2,
        23
      ],
      "name": "Kawther Ben Abdelghani"
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      "name": "Antonella Abi Najm"
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      "name": "Laila Ayoub"
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      "name": "Rachida Allat"
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      "name": "Laila Aljazwi"
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      "name": "Malik Djennane"
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      "name": "Dhouha Khalifa"
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      "name": "Ziryab Mahmoud"
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      "name": "Ines Mahmoud"
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      "name": "Asal Ridha Adnan"
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      "name": "Hanan Alrayes"
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      "name": "Saed I Y Attawna"
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      "name": "Faiq I Gorial",
      "orcid": "0000-0002-2760-5566"
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      "name": "Nabaa Ihsan Awadh",
      "orcid": "0000-0002-7634-0146"
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      "name": "Hiba Boussaa",
      "orcid": "0000-0002-4744-5766"
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      "name": "Maxime Dougados",
      "orcid": "0000-0003-3009-6229"
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    {
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        32,
        33
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      "name": "Ihsane Hmamouchi",
      "orcid": "0000-0003-4402-5034"
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  "bibtex": "https://research.draconitic.com/paper/89e8z2qz63f0x.bib",
  "cited_by": 0,
  "doi": "10.1136/rmdopen-2026-007136",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13735387/",
  "id": "89e8z2qz63f0x",
  "issns": [
    "2056-5933"
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  "landing_url": "https://doi.org/10.1136/rmdopen-2026-007136",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "1506"
    ],
    [
      "heading",
      "Original Research"
    ],
    [
      "heading",
      "Spondyloarthritis"
    ],
    [
      "openalex",
      "2745|Spondyloarthritis Studies and Treatments"
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  ],
  "openalex": "W7225239038",
  "pdf_url": "https://rmdopen.bmj.com/content/12/4/e007136.full.pdf",
  "pmcid": "PMC13735387",
  "pmid": "42982516",
  "published": "2026-11-04",
  "publisher": "BMJ Publishing Group",
  "ris": "https://research.draconitic.com/paper/89e8z2qz63f0x.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:21:04Z",
      "native_id": "PMC13735387",
      "source": "pmc",
      "url": "https://doi.org/10.1136/rmdopen-2026-007136"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2745|Spondyloarthritis Studies and Treatments",
      "subfield": "general"
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  ],
  "title": "Clinical phenotype, disease burden and inter-regional heterogeneity of axial spondyloarthritis in 1112 patients across 15 Arab countries: the PROSPA study",
  "title_text": "Clinical phenotype, disease burden and inter-regional heterogeneity of axial spondyloarthritis in 1112 patients across 15 Arab countries: the PROSPA study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:21:04Z",
  "url": "https://research.draconitic.com/paper/89e8z2qz63f0x",
  "venue": "RMD Open",
  "versions": []
}