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

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 a...

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Published inRheumatic & musculoskeletal diseases open Vol. 7; no. 1; p. e001450
Main Authors López-Medina, Clementina, Molto, Anna, Sieper, Joachim, Duruöz, Tuncay, Kiltz, Uta, Elzorkany, Bassel, Hajjaj-Hassouni, Najia, Burgos-Vargas, Ruben, Maldonado-Cocco, José, Ziade, Nelly, Gavali, Meghna, Navarro-Compan, Victoria, Luo, Shue-Fen, Monti, Sara, Tae-Jong, Kim, Kishimoto, Mitsumasa, Pimentel-Santos, F M, Gu, Jieruo, Schiotis, Ruxandra, van Gaalen, Floris A, Geher, Pál, Magrey, Marina, Ibáñez Vodnizza, Sebastián E, Bautista-Molano, Wilson, Maksymowych, Walter, Machado, Pedro M, Landewé, Robert, van der Heijde, Desirée, Dougados, Maxime
Format Journal Article
LanguageEnglish
Published England EULAR 01.01.2021
BMJ Publishing Group LTD
BMJ Publishing Group
SeriesOriginal research
Subjects
ankylosing
Arthritis
Classification
Demographics
Disease
Fibromyalgia
Inflammatory bowel disease
juvenile
Natural history
Patients
Psoriasis
psoriatic
Psoriatic arthritis
spondylitis
Spondyloarthritis
Middle East
Canada
United States > US
Asia
Europe
North Africa
North America
Latin America
spondylitis
psoriatic
juvenile
arthritis
ankylosing
Online AccessGet full text
ISSN2056-5933
2056-5933
DOI10.1136/rmdopen-2020-001450

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Abstract 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.
AbstractList 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.
To characterise peripheral musculoskeletal involvement in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), across the world. 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. 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%). 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.
To characterise peripheral musculoskeletal involvement in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), across the world.OBJECTIVESTo characterise peripheral musculoskeletal involvement in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), across the world.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.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.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%).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%).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.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.
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.
Author 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
AuthorAffiliation 16 Department of Rheumatology , Chonnam National University Medical School and Hospital , Gwangju , South Korea
15 Rheumatology Department , Fondazione IRCCS Policlinico S Matteo, University of Pavia , Pavia , Italy
3 Rheumatology Department , Reina Sofia University Hospital, IMIBIC, University of Córdoba , Córdoba , Spain
30 Department of Rheumatology , Northwick Park Hospital, London North West University Healthcare NHS Trust , London , UK
33 Rheumatology , Université de Paris Descartes , Paris , France
25 Rheumatology , Facultad de Medicina Clínica Alemana – Universidad del Desarrollo , Santiago , Chile
5 PMR Department, Rheumatology Division , Marmara University School of Medicine , Istanbul , Turkey
2 ECAMO , INSERM (U1153): Clinical Epidemiology and Biostatistics, University of Paris , Paris , France
14 Department of Rheumatology, Allergy and Immunology , Chang Gung Memorial Hospital-Linkou , Taoyuan , Taiwan
11 Rheumatology Department , Saint-Joseph University and Mount Lebanon Hospital
AuthorAffiliation_xml – name: 11 Rheumatology Department , Saint-Joseph University and Mount Lebanon Hospital , Beirut , Lebanon
– name: 9 Rheumatology Department , Hospital General de México Eduardo Liceaga , Mexico City , Mexico
– name: 31 Rheumatology , Amsterdam Rheumatology Center, AMC , Amsterdam , Netherlands
– name: 20 Pharmacology Department , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj-Napoca , Romania
– name: 28 Centre for Rheumatology and Department of Neuromuscular Diseases , University College of London , London , UK
– name: 6 Rheumatology , Rheumazentrum Ruhrgebiet, Ruhr-University Bochum , Herne , Germany
– name: 32 Rheumatology Department , Zuyderland MC , Heerlen , The Netherlands
– name: 7 Rheumatology Department , Cairo University , Cairo , Egypt
– name: 17 Department of Nephrology and Rheumatology , Kyorin University School of Medicine , Tokyo , Japan
– name: 16 Department of Rheumatology , Chonnam National University Medical School and Hospital , Gwangju , South Korea
– name: 29 Department of Rheumatology , University College London Hospitals NHS Foundation Trust , London , UK
– name: 5 PMR Department, Rheumatology Division , Marmara University School of Medicine , Istanbul , Turkey
– name: 14 Department of Rheumatology, Allergy and Immunology , Chang Gung Memorial Hospital-Linkou , Taoyuan , Taiwan
– name: 18 Rheumatology , NOVA Medical School, Nova University of Lisbon , Lisboa , Portugal
– name: 8 Rheumatology , Health Sciences College, International University of Rabat (UIR) , Rabat , Morocco
– name: 12 Department of Rheumatology , Nizam's Institute of Medical Sciences , Hyderabad , Telangana , India
– name: 24 Rheumatology Department , Case Western Reserve University School of Medicine , Cleveland , Ohio , USA
– name: 26 Rheumatology Department , University Hospital Fundación Santa Fé de Bogotá and Universidad El Bosque , Bogotá , Colombia
– name: 1 Rheumatology Department , Cochin Hospital, Assistance Publique Hôpitaux de Paris , Paris , France
– name: 21 Rheumatology Department , SCBI , Cluj-Napoca , Romania
– name: 23 Rheumatology Department , Semmelweis Egyetem , Budapest , Hungary
– name: 10 Rheumatology , Buenos Aires University School of Medicine , Buenos Aires , Argentina
– name: 25 Rheumatology , Facultad de Medicina Clínica Alemana – Universidad del Desarrollo , Santiago , Chile
– name: 22 Rheumatology Department , Leiden University Medical Center , Leiden , The Netherlands
– name: 15 Rheumatology Department , Fondazione IRCCS Policlinico S Matteo, University of Pavia , Pavia , Italy
– name: 2 ECAMO , INSERM (U1153): Clinical Epidemiology and Biostatistics, University of Paris , Paris , France
– name: 27 Medicine Department , University of Alberta , Edmonton , Alberta , Canada
– name: 19 Rheumatology Department , The Third Affiliated Hospital of Sun Yat-Sen University , Guangzhou , China
– name: 4 Department of Gastroenterology, Infectious Diseases and Rheumatology , Charité University , Berlin , Germany
– name: 30 Department of Rheumatology , Northwick Park Hospital, London North West University Healthcare NHS Trust , London , UK
– name: 33 Rheumatology , Université de Paris Descartes , Paris , France
– name: 3 Rheumatology Department , Reina Sofia University Hospital, IMIBIC, University of Córdoba , Córdoba , Spain
– name: 13 Rheumatology Department , University Hospital La Paz, IdiPaz , Madrid , Spain
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  givenname: Clementina
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  email: clementinalopezmedina@gmail.com
  organization: Rheumatology Department, Reina Sofia University Hospital, IMIBIC, University of Córdoba, Córdoba, Spain
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  orcidid: 0000-0003-0722-6822
  surname: Hajjaj-Hassouni
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  organization: Rheumatology, Health Sciences College, International University of Rabat (UIR), Rabat, Morocco
– sequence: 8
  givenname: Ruben
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  organization: Rheumatology Department, Hospital General de México Eduardo Liceaga, Mexico City, Mexico
– sequence: 9
  givenname: José
  surname: Maldonado-Cocco
  fullname: Maldonado-Cocco, José
  organization: Rheumatology, Buenos Aires University School of Medicine, Buenos Aires, Argentina
– sequence: 10
  givenname: Nelly
  orcidid: 0000-0002-4479-7678
  surname: Ziade
  fullname: Ziade, Nelly
  organization: Rheumatology Department, Saint-Joseph University and Mount Lebanon Hospital, Beirut, Lebanon
– sequence: 11
  givenname: Meghna
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  organization: Department of Rheumatology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
– sequence: 12
  givenname: Victoria
  surname: Navarro-Compan
  fullname: Navarro-Compan, Victoria
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  givenname: Shue-Fen
  surname: Luo
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  organization: Department of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan
– sequence: 14
  givenname: Sara
  orcidid: 0000-0002-1800-6772
  surname: Monti
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  organization: Rheumatology Department, Fondazione IRCCS Policlinico S Matteo, University of Pavia, Pavia, Italy
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  givenname: Kim
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  organization: Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, South Korea
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  givenname: Mitsumasa
  surname: Kishimoto
  fullname: Kishimoto, Mitsumasa
  organization: Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan
– sequence: 17
  givenname: F M
  surname: Pimentel-Santos
  fullname: Pimentel-Santos, F M
  organization: Rheumatology, NOVA Medical School, Nova University of Lisbon, Lisboa, Portugal
– sequence: 18
  givenname: Jieruo
  surname: Gu
  fullname: Gu, Jieruo
  organization: Rheumatology Department, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
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  givenname: Ruxandra
  surname: Schiotis
  fullname: Schiotis, Ruxandra
  organization: Rheumatology Department, SCBI, Cluj-Napoca, Romania
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  givenname: Floris A
  orcidid: 0000-0001-8448-7407
  surname: van Gaalen
  fullname: van Gaalen, Floris A
  organization: Rheumatology Department, Leiden University Medical Center, Leiden, The Netherlands
– sequence: 21
  givenname: Pál
  surname: Geher
  fullname: Geher, Pál
  organization: Rheumatology Department, Semmelweis Egyetem, Budapest, Hungary
– sequence: 22
  givenname: Marina
  surname: Magrey
  fullname: Magrey, Marina
  organization: Rheumatology Department, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
– sequence: 23
  givenname: Sebastián E
  orcidid: 0000-0002-9577-3078
  surname: Ibáñez Vodnizza
  fullname: Ibáñez Vodnizza, Sebastián E
  organization: Rheumatology, Facultad de Medicina Clínica Alemana – Universidad del Desarrollo, Santiago, Chile
– sequence: 24
  givenname: Wilson
  orcidid: 0000-0003-0684-9542
  surname: Bautista-Molano
  fullname: Bautista-Molano, Wilson
  organization: Rheumatology Department, University Hospital Fundación Santa Fé de Bogotá and Universidad El Bosque, Bogotá, Colombia
– sequence: 25
  givenname: Walter
  surname: Maksymowych
  fullname: Maksymowych, Walter
  organization: Medicine Department, University of Alberta, Edmonton, Alberta, Canada
– sequence: 26
  givenname: Pedro M
  orcidid: 0000-0002-8411-7972
  surname: Machado
  fullname: Machado, Pedro M
  organization: Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
– sequence: 27
  givenname: Robert
  surname: Landewé
  fullname: Landewé, Robert
  organization: Rheumatology Department, Zuyderland MC, Heerlen, The Netherlands
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  givenname: Desirée
  orcidid: 0000-0002-5781-158X
  surname: van der Heijde
  fullname: van der Heijde, Desirée
  organization: Rheumatology Department, Leiden University Medical Center, Leiden, The Netherlands
– sequence: 29
  givenname: Maxime
  surname: Dougados
  fullname: Dougados, Maxime
  organization: Rheumatology, Université de Paris Descartes, Paris, France
BackLink https://www.ncbi.nlm.nih.gov/pubmed/33462157$$D View this record in MEDLINE/PubMed
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Issue 1
Keywords spondylitis
psoriatic
juvenile
arthritis
ankylosing
Language English
License This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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Snippet ObjectivesTo characterise peripheral musculoskeletal involvement in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), across the...
To characterise peripheral musculoskeletal involvement in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), across the world....
To characterise peripheral musculoskeletal involvement in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), across the...
Objectives To characterise peripheral musculoskeletal involvement in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), across the...
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proquest
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Enrichment Source
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StartPage e001450
SubjectTerms ankylosing
Arthritis
Classification
Demographics
Disease
Fibromyalgia
Inflammatory bowel disease
juvenile
Natural history
Patients
Psoriasis
psoriatic
Psoriatic arthritis
spondylitis
Spondyloarthritis
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Title Prevalence and distribution of peripheral musculoskeletal manifestations in spondyloarthritis including psoriatic arthritis: results of the worldwide, cross-sectional ASAS-PerSpA study
URI https://rmdopen.bmj.com/content/7/1/e001450.full
https://www.ncbi.nlm.nih.gov/pubmed/33462157
https://www.proquest.com/docview/2479948901
https://www.proquest.com/docview/2479041222
https://pubmed.ncbi.nlm.nih.gov/PMC7816910
https://doaj.org/article/27ac15f455aa4e1fb8047044ae9d5232
Volume 7
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