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

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 GaalenPál Geher, Marina Magrey, Sebastián E. Ibáñez Vodnizza, Wilson Bautista-Molano, Walter Maksymowych, Pedro M. Machado, Robert Landewé, Desirée Van Der Heijde, Maxime Dougados

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Article numbere001450
JournalRMD Open
Volume7
Issue number1
DOIs
Publication statusPublished - Jan 18 2021

Keywords

  • ankylosing
  • arthritis
  • juvenile
  • psoriatic
  • spondylitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology

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