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Arthritis Res Ther. 2019 Jun 6;21(1):139. doi: 10.1186/s13075-019-1927-6.

Evaluation of concomitant peripheral arthritis in patients with recent onset axial spondyloarthritis: 5-year results from the DESIR cohort.

Author information

1
Rheumatology Department, Cochin Hospital, 27 rue du Faubourg Saint Jacques, 75014, Paris, France. clementinalopezmedina@gmail.com.
2
Inserm (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France. clementinalopezmedina@gmail.com.
3
University of Córdoba, Córdoba, Spain. clementinalopezmedina@gmail.com.
4
Rheumatology Department, Cochin Hospital, 27 rue du Faubourg Saint Jacques, 75014, Paris, France.
5
Inserm (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France.
6
Rhumatologie et Immunologie Clinique, CHU Purpan, Toulouse, France.

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.

METHODS:

Data 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.

RESULTS:

Out 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.

CONCLUSION:

In 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.

KEYWORDS:

Axial spondyloarthritis; Clinical presentation; Peripheral arthritis

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