RT Journal Article
SR Electronic
T1 Prevalence and distribution of peripheral musculoskeletal manifestations in spondyloarthritis including psoriatic arthritis: results of the worldwide, cross-sectional ASAS-PerSpA study
JF RMD Open
JO RMD Open
FD EULAR
SP e001450
DO 10.1136/rmdopen-2020-001450
VO 7
IS 1
A1 Clementina López-Medina
A1 Anna Molto
A1 Joachim Sieper
A1 Tuncay Duruöz
A1 Uta Kiltz
A1 Bassel Elzorkany
A1 Najia Hajjaj-Hassouni
A1 Ruben Burgos-Vargas
A1 José Maldonado-Cocco
A1 Nelly Ziade
A1 Meghna Gavali
A1 Victoria Navarro-Compan
A1 Shue-Fen Luo
A1 Sara Monti
A1 Kim Tae-Jong
A1 Mitsumasa Kishimoto
A1 F M Pimentel-Santos
A1 Jieruo Gu
A1 Ruxandra Schiotis
A1 Floris A van Gaalen
A1 Pál Geher
A1 Marina Magrey
A1 Sebastián E Ibáñez Vodnizza
A1 Wilson Bautista-Molano
A1 Walter Maksymowych
A1 Pedro M Machado
A1 Robert Landewé
A1 Desirée van der Heijde
A1 Maxime Dougados
YR 2021
UL http://rmdopen.bmj.com/content/7/1/e001450.abstract
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.