The management of spondyloarthritis in sub-Saharan Africa: a real-world cohort from Kinshasa, Democratic Republic of the Congo.

Objectives: Data on SpA in sub-Saharan Africa are limited. This study aimed to describe the clinical course and progression of SpA in Congolese patients treated with NSAIDs and physiotherapy and to explore patients' perceptions of the disease and its treatment. Methods: This 24-week study involved patients recently diagnosed with SpA and starting treatment over 2 years in the outpatient clinic of the University Hospital of Kinshasa. Demographic and clinical data, including the BASDAI, BASFI and BASMI, were collected at enrolment. All patients were treated with NSAIDs and took part in physical exercise. Assessments were conducted at baseline and weeks 6, 12 and 24. A regression analysis identified factors associated with BASDAI scores >4. Results: A total of 258 patients were initially enrolled [49% male, mean age 46.5 (s.d. 14.5)]. Of these, 177 completed the study. At baseline, 63.8% had chronic inflammatory low back pain, 42.8% had peripheral arthritis, 46.3% had heel enthesitis and 18.1% had anterior uveitis. At baseline and weeks 6, 12 and 24, the median BASDAI levels were 3.1, 1.9, 0.5 and 0, respectively, and the ASDAS-CRP score declined from 2.1 at baseline to 1.1 at week 24. A total of 37 patients (33.6%) reported a poor perception of their disease. Those with a disease duration of >7 years had greater psychological distress [odds ratio 3.30 (95% CI 1.42, 7.69), Conclusions: First-line therapy combining NSAIDs and physiotherapy with regular follow-up yielded favourable clinical outcomes in Congolese patients with SpA.