PT  - JOURNAL ARTICLE
AU  - López-Medina, Clementina
AU  - Molto, Anna
AU  - Sieper, Joachim
AU  - Duruöz, Tuncay
AU  - Kiltz, Uta
AU  - Elzorkany, Bassel
AU  - Hajjaj-Hassouni, Najia
AU  - Burgos-Vargas, Ruben
AU  - Maldonado-Cocco, José
AU  - Ziade, Nelly
AU  - Gavali, Meghna
AU  - Navarro-Compan, Victoria
AU  - Luo, Shue-Fen
AU  - Monti, Sara
AU  - Tae-Jong, Kim
AU  - Kishimoto, Mitsumasa
AU  - Pimentel-Santos, F M
AU  - Gu, Jieruo
AU  - Schiotis, Ruxandra
AU  - van Gaalen, Floris A
AU  - Geher, Pál
AU  - Magrey, Marina
AU  - Ibáñez Vodnizza, Sebastián E
AU  - Bautista-Molano, Wilson
AU  - Maksymowych, Walter
AU  - Machado, Pedro M
AU  - Landewé, Robert
AU  - van der Heijde, Desirée
AU  - Dougados, Maxime
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.