PT  - JOURNAL ARTICLE
AU  - Clementina López-Medina
AU  - Anna Molto
AU  - Joachim Sieper
AU  - Tuncay Duruöz
AU  - Uta Kiltz
AU  - Bassel Elzorkany
AU  - Najia Hajjaj-Hassouni
AU  - Ruben Burgos-Vargas
AU  - José Maldonado-Cocco
AU  - Nelly Ziade
AU  - Meghna Gavali
AU  - Victoria Navarro-Compan
AU  - Shue-Fen Luo
AU  - Sara Monti
AU  - Kim Tae-Jong
AU  - Mitsumasa Kishimoto
AU  - F M Pimentel-Santos
AU  - Jieruo Gu
AU  - Ruxandra Schiotis
AU  - Floris A van Gaalen
AU  - Pál Geher
AU  - Marina Magrey
AU  - Sebastián E Ibáñez Vodnizza
AU  - Wilson Bautista-Molano
AU  - Walter Maksymowych
AU  - Pedro M Machado
AU  - Robert Landewé
AU  - Desirée van der Heijde
AU  - Maxime Dougados
TI  - Prevalence and distribution of peripheral musculoskeletal manifestations in spondyloarthritis including psoriatic arthritis: results of the worldwide, cross-sectional ASAS-PerSpA study
AID  - 10.1136/rmdopen-2020-001450
DP  - 2021 Jan 01
TA  - RMD Open
PG  - e001450
VI  - 7
IP  - 1
4099  - http://rmdopen.bmj.com/content/7/1/e001450.short
4100  - http://rmdopen.bmj.com/content/7/1/e001450.full
SO  - RMD Open2021 Jan 01; 7
AB  - Objectives To characterise peripheral musculoskeletal involvement in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), across the world.Methods Cross-sectional study with 24 participating countries. Patients with a diagnosis of axial SpA (axSpA), peripheral SpA (pSpA) or PsA according to their rheumatologist were included. The investigators were asked which diagnosis out of a list of six (axSpA, PsA, pSpA, inflammatory bowel disease-associated SpA, reactive arthritis or juvenile SpA (Juv-SpA)) fitted the patient best. Peripheral manifestations (ie, peripheral joint disease, enthesitis, dactylitis and root joint disease), their localisation and treatments were evaluated.Results A total of 4465 patients were included (61% men, mean age 44.5 years) from four geographic areas: Latin America (n=538), Europe plus North America (n=1677), Asia (n=975) and the Middle East plus North Africa (n=1275). Of those, 78% had ever suffered from at least one peripheral musculoskeletal manifestation; 57% had peripheral joint disease, 44% had enthesitis and 15% had dactylitis. Latin American had far more often peripheral joint disease (80%) than patients from other areas. Patients with PsA had predominantly upper limb and small joint involvement (52%).Hip and shoulder involvement was found in 34% of patients. The prevalence of enthesitis ranged between 41% in patients with axSpA and 65% in patients with Juv-SpA. Dactylitis was most frequent among patients with PsA (37%).Conclusion These results suggest that all peripheral features can be found in all subtypes of SpA, and that differences are quantitative rather than qualitative. In a high proportion of patients, axial and peripheral manifestations coincided. These findings reconfirm SpA clinical subtypes are descendants of the same underlying disease, called SpA.