{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T08:22:16Z","timestamp":1777623736398,"version":"3.51.4"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T00:00:00Z","timestamp":1732665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ACR Open Rheumatology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Axial spondyloarthritis (axSpA) is an immune\u2010mediated disease that predominantly affects the axial skeleton. The objective of this study was to describe the frequency and clinical characteristics of axSpA in Black Americans in Shelby County. We also aimed to report diagnostic delays, disease severity, and health disparities in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective observational study in which electronic records of patients with axSpA were reviewed across five centers in Shelby County. Patients were identified using International Classification of Diseases codes. Data on demographics, clinical characteristics, and imaging were collected. The frequency was reported. Two\u2010group comparisons were done using the chi\u2010square test and two\u2010sample <jats:italic>t<\/jats:italic>\u2010test. Multivariable logistic and linear regression methods were used to compare sacroiliitis grades and delay in diagnosis, respectively, after adjusting for confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Black Americans constituted 32% (n = 78) of the 244 patients with axSpA identified. Black Americans had significantly more hip involvement, more elevations in C\u2010reactive protein, less <jats:italic>HLA\u2013B27<\/jats:italic> positivity, and less family history positivity when compared with White patients. After adjusting for age, sex, and <jats:italic>HLA\u2013B27<\/jats:italic>, Black Americans had twice as higher odds of having advanced grades of sacroiliitis on x\u2010rays compared to White Americans (odds ratio 2.32 [95% confidence interval 1.23\u20134.44]). AxSpA was associated with significant diagnostic delays in both races.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A significant proportion of patients with axSpA in Shelby County were Black Americans. The study identified that Black Americans have more odds of having advanced sacroiliitis on x\u2010rays, more hip involvement, and higher markers of inflammation. It also showed that, regardless of race or ethnicity, there is a significant diagnostic delay.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr2.11769","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T05:34:16Z","timestamp":1732685656000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Axial Spondyloarthritis in Black Americans: An Observational Study From Five Centers in Shelby County, Tennessee"],"prefix":"10.1002","volume":"7","author":[{"given":"Krishna","family":"Kommineni","sequence":"first","affiliation":[{"name":"The University of Tennessee Health Service Center  Memphis"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iman","family":"Abutineh","sequence":"additional","affiliation":[{"name":"The University of Tennessee Health Service Center  Memphis"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cathy","family":"Chapman","sequence":"additional","affiliation":[{"name":"The University of Tennessee Health Service Center  Memphis"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5751-7022","authenticated-orcid":false,"given":"Debendra","family":"Pattanaik","sequence":"additional","affiliation":[{"name":"The University of Tennessee Health Service Center  Memphis"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad","family":"Bittar","sequence":"additional","affiliation":[{"name":"Oregon Health &amp; Science University  Portland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,11,27]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaa807"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaa472"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2012.09.003"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr2.11555"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.33503"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAJ.0b013e318294457f"},{"key":"e_1_2_7_8_1","volume-title":"Hispanic of Latino, and not Hispanic or Latino, by race","year":"2020"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780140103"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-017-3767-6"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.181019"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2018.12.032"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-014-2763-3"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.191399"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwab199"},{"key":"e_1_2_7_16_1","first-page":"39","article-title":"HLA B27 in ankylosing spondylitis: differences in frequency and relative risk in American Blacks and Caucasians","volume":"3","author":"Khan MA","year":"1977","journal-title":"J Rheumatol Suppl"},{"issue":"1","key":"e_1_2_7_17_1","first-page":"41","article-title":"Race\u2010related differences in HLA association with ankylosing spondylitis and Reiter's disease in American blacks and whites","volume":"70","author":"Khan MA","year":"1978","journal-title":"J Natl Med Assoc"}],"container-title":["ACR Open Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr2.11769","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T15:25:55Z","timestamp":1759418755000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr2.11769"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,27]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1002\/acr2.11769"],"URL":"https:\/\/doi.org\/10.1002\/acr2.11769","archive":["Portico"],"relation":{},"ISSN":["2578-5745","2578-5745"],"issn-type":[{"value":"2578-5745","type":"print"},{"value":"2578-5745","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,27]]},"assertion":[{"value":"2024-08-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e11769"}}