Prevalence and distribution of peripheral musculoskeletal manifestations in spondyloarthritis including psoriatic arthritis: results of the worldwide, cross-sectional ASAS-PerSpA study
Journal
RMD Open
ISSN
2056-5933
Date Issued
2021
Author(s)
Clementina López-Medina
Anna Molto
Joachim Sieper
Tuncay Duruöz
Uta Kiltz
Bassel Elzorkany
Najia Hajjaj-Hassouni
Ruben Burgos-Vargas
José Maldonado-Cocco
Nelly Ziade
Meghna Gavali
Victoria Navarro-Compan
Shue-Fen Luo
Sara Monti
Kim Tae-Jong
Mitsumasa Kishimoto
F M Pimentel-Santos
Jieruo Gu
Ruxandra Schiotis
Floris A van Gaalen
Pál Geher
Marina Magrey
Sebastián E Ibáñez Vodnizza
Wilson Bautista-Molano
Walter Maksymowych
Pedro M Machado
Robert Landewé
Desirée van der Heijde
Maxime Dougados
Type
Resource Types::text::journal::journal article
URL Institutional Repository
Abstract
<jats:sec><jats:title>Objectives</jats:title><jats:p>To characterise peripheral musculoskeletal involvement in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), across the world.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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%).</jats:p><jats:p>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%).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>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.</jats:p></jats:sec>
Subjects
spondylitis
;
ankylosing
;
arthritis
;
psoriatic
;
arthritis
;
juvenile
;
adult
;
arthritis, psoriatic
;
cross-sectional studies
;
female
;
humans
;
male
;
prevalence
;
spondylarthritis
;
spondylitis, ankylosing
;
biological product
;
disease modifying antirheumatic drug
;
glucocorticoid
;
nonsteroid antiinflammatory agent
;
adult
;
arthropathy
;
article
;
asia
;
cross-sectional study
;
dactylitis
;
enthesitis
;
europe
;
female
;
human
;
inflammatory bowel disease
;
juvenile spondylarthritis
;
major clinical study
;
male
;
middle east
;
musculoskeletal disease
;
north africa
;
north america
;
observational study
;
peripheral spondyloarthritis
;
prevalence
;
psoriatic arthritis
;
reactive arthritis
;
rheumatologist
;
south and central america
;
spondylarthritis
;
ankylosing spondylitis
;
psoriatic arthritis
;
spondylarthritis