Abstract
Background(a) To describe the prevalence and incidence of peripheral arthritis during 5 years of follow-up in recent axial spondyloarthritis (axSpA), (b) to evaluate factors associated with their appearance and (c) to assess their impact on treatment, patient-reported outcomes and sick leave after follow-up.MethodsData from the early axSpA patients from the DESIR cohort (first 5 years of follow-up) were analysed. Prevalence and incidence of peripheral arthritis at each study visit were calculated. A multivariate analysis was performed to evaluate baseline factors associated with the development of the arthritis. The use of drugs, the impact on patient-reported outcomes and days of sick leave were compared in both groups over time.ResultsOut of the 708 patients included in DESIR, 255 (36.0%) showed at least one episode of arthritis (151 before the inclusion visit and 104 during the follow-up), with an incidence of 3.7 cases per 100 person-years. Patients with peripheral arthritis were more likely (OR, 95%CI) to be aged ≥ 33 years (1.60, 1.12–2.27), non-smokers (1.58, 1.10–2.27) and HLAB27 negative (1.47, 1.04–2.08) and have presented with at least one episode of dactylitis (8.50, 4.96–14.60) and enthesitis (2.00, 1.41–2.84). Patients with peripheral arthritis showed a significant greater use of TNFb, csDMARDs and corticosteroids over follow-up; higher levels on BASDAI (40.46 vs. 34.28) and BASFI (27.89 vs. 22.52); poorer quality of life; and higher number of days of sick leave (17.97 vs. 12.78) over time.ConclusionIn recent axSpA, 36% of patients reported peripheral arthritis at any time of the disease, being associated with negative HLAB27, non-smokers and with other peripheral manifestations. Patients with arthritis showed a higher burden of disease.
Highlights
Spondyloarthritis (SpA) is a chronic inflammatory disease that affects the axial skeleton, peripheral joints and enthesis [1]
SpA has been classically divided into subtypes, such as ankylosing spondylitis (AS), psoriatic arthritis (PsA), reactive arthritis, SpA associated with inflammatory bowel disease (IBD) and undifferentiated SpA
Prevalence and incidence of peripheral arthritis Out of the 708 patients included in the analysis, a total of 255 [36.0% (95%CI 32.6–39.6)] patients suffered from peripheral arthritis at any time during the disease course (Fig. 1)
Summary
Spondyloarthritis (SpA) is a chronic inflammatory disease that affects the axial skeleton, peripheral joints and enthesis [1]. SpA has been classically divided into subtypes, such as ankylosing spondylitis (AS), psoriatic arthritis (PsA), reactive arthritis, SpA associated with inflammatory bowel disease (IBD) and undifferentiated SpA. In 2009, the publication of the ASAS. Arthritis and enthesitis are the most common peripheral features in axSpA and can be found predominantly in the lower limbs [1]. The prevalence of peripheral arthritis has been well described in AS patients, with percentages ranging between 22 and 30% [3]. The prevalence of this manifestation in the whole group of axSpA varies between the different cohorts.
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