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Clin Exp Rheumatol. 2018 Dec 19. [Epub ahead of print]

Clinical peripheral enthesitis in the DESIR prospective longitudinal axial spondyloarthritis cohort.

Author information

1
Institut de Rhumatologie de Montréal, Canada.
2
Paris Descartes University Department of Rheumatology, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, France.
3
CHUL, Quebec, Canada.
4
Division of Rheumatology, Department of Medicine, CHU de Québec-Université Laval, and Centre de Recherche du CHU de Québec-Université Laval, Canada.
5
Rheumatology Department, APHP, Hôpital Ambroise Paré, Boulogne-Billancourt, and INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, France.
6
Hôpital Henri Mondor, Créteil, France.
7
CHRU, Besançon, France.
8
Department of Rheumatology, Centre Hospitalier de l'Université de Montréal, Canada.
9
Paris Descartes University Department of Rheumatology, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, and INSERM U1153, Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France. maxime.dougados@aphp.fr.

Abstract

OBJECTIVES:

We aimed to describe the prevalence and characteristics of peripheral enthesitis in recent onset axial spondyloarthritis, estimate the incidence of peripheral enthesitis over time, and determine the factors associated with the presence of peripheral enthesitis.

METHODS:

708 patients with recent onset axial spondyloarthritis were enrolled in the DESIR cohort ( prospective multi-centre, longitudinal). Data regarding the patients and spondyloarthritis characteristics at baseline with a specific focus on enthesitis and occurrence of peripheral enthesitis were collected during the five years of follow-up.

RESULTS:

At inclusion, 395 patients (55.8%) reported peripheral enthesitis. The locations were mainly the plantar fascia (53.7%) and the Achilles tendon (38.5%). During the 5-year follow-up period, 109 additional patients developed peripheral enthesitis resulting in an estimated (Kaplan-Meier method) percentage of 71% (95% CI: 68-75). Variables associated with peripheral enthesitis in the univariate analysis were: older age, male gender, absence of HLA B27, MRI sacroiliitis and fulfilled Modified NY criteria, presence of anterior chest wall pain, peripheral arthritis, dactylitis, psoriasis, high BASDAI, BASFI, mean score ASAS-and the use of NSAIDs. Only the history of anterior chest wall pain and of peripheral arthritis were retained in the multivariate analysis (odds ratio (OR)=1.6 [95% confidence interval [1.1-2.3], and OR=2.1 [1.4-3.0], respectively).

CONCLUSIONS:

This study highlights the high prevalence of peripheral enthesitis in recent onset axial spondyloarthritis, and suggests that in combination with peripheral arthritis, enthesitis might have an impact on the burden of the disease.

PMID:
30620273

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