Global prevalence of ankylosing spondylitis

Linda E. Dean, Gareth T Jones, Alan G MacDonald, Christina Downham, Roger D Sturrock, Gary J Macfarlane

Research output: Contribution to journalArticlepeer-review

417 Citations (Scopus)


OBJECTIVES: For effective health care provision, knowledge of disease prevalence is paramount. There has been no systematic endeavour to establish continent-based AS estimates, however, prevalence is thought to vary by country and background HLA-B27 prevalence. This study aimed to estimate AS prevalence worldwide and to calculate the expected number of cases.

METHODS: A systematic literature search was conducted. Prevalence data were extracted and used to calculate the mean prevalence by continent and the expected number of cases based on country-specific prevalence (or, if missing, the prevalence from neighbouring countries). A second estimate was made using the prevalence from countries with similar HLA-B27 prevalences if a country-specific prevalence estimate was not available.

RESULTS: The mean AS prevalence per 10,000 (from 36 eligible studies) was 23.8 in Europe, 16.7 in Asia, 31.9 in North America, 10.2 in Latin America and 7.4 in Africa. Additional estimates, weighted by study size, were calculated as 18.6, 18.0 and 12.2 for Europe, Asia and Latin America, respectively. There were sufficient studies to estimate the number of cases in Europe and Asia, calculated to be 1.30-1.56 million and 4.63-4.98 million, respectively.

CONCLUSION: This study represents the first systematic attempt to collate estimates of AS prevalence into a single continent-based estimate. In addition, the number of expected cases in Europe and Asia was estimated. Through reviewing the current literature, it is apparent that the continuing conduct of epidemiological studies of AS prevalence is of great importance, particularly as diagnostic capabilities improve and with the recent development of the criteria for axial SpA.

Original languageEnglish
Pages (from-to)650-657
Number of pages8
Issue number4
Early online date9 Dec 2013
Publication statusPublished - Apr 2014

Bibliographical note

L.E.D. was supported by a UK Medical Research Council
PhD studentship.

Disclosure statement: G.T.J., R.D.S. and G.J.M. have
received funding from AbbVie Pharmaceuticals and
Pfizer for studies to estimate the prevalence of AS. No
data from these studies were eligible for this review. All
other authors have declared no conflicts of interest.

Supplementary data
Supplementary data are available at Rheumatology


  • Africa
  • Asia
  • Europe
  • HLA-B27 Antigen
  • Humans
  • Latin America
  • North America
  • Prevalence
  • Spondylitis, Ankylosing
  • World Health
  • Spondyloarthropathies
  • Epidemiology
  • Systematic Review


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