Journal Article

Prevalence and distribution of peripheral musculoskeletal manifestations in spondyloarthritis including psoriatic arthritis: results of the worldwide, cross-sectional ASAS-PerSpA study

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

2021

Overview

ObjectivesTo characterise peripheral musculoskeletal involvement in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), across the world.MethodsCross-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.ResultsA 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%).ConclusionThese 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.

• Publisher: EULAR,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: ankylosing / Arthritis / Classification / Demographics / Disease / Fibromyalgia / Inflammatory bowel disease / juvenile / Natural history / Patients / Psoriasis / psoriatic / Psoriatic arthritis / spondylitis / Spondyloarthritis