scholarly journals How Should We Measure Peripheral Spondyloarthritis?

2021 ◽  
pp. jrheum.211043
Author(s):  
Laura C. Coates ◽  
William Tillett
Keyword(s):  
Peripheral Arthritis ◽  
Peripheral Spondyloarthritis ◽  
Axial Involvement

Spondyloarthritis (SpA) is recognized as an overarching spectrum of disease characterized by axial SpA (axSpA), peripheral arthritis, enthesitis, and dactylitis. Despite significant overlap, patients are often characterized as having predominantly peripheral or axial involvement.

Axial Involvement in Psoriatic Arthritis: Effect on Peripheral Arthritis and Differential Features With Axial Spondyloarthritis in South America

2021 ◽  
pp. jrheum.201627
Author(s):  
Rodrigo García Salinas ◽  
Einer Sanchez Prado ◽  
Santiago Ruta
Keyword(s):  
Psoriatic Arthritis ◽  
Ankylosing Spondylitis ◽  
South America ◽  
Axial Spondyloarthritis ◽  
Hla B27 ◽  
Skin Involvement ◽  
Peripheral Arthritis ◽  
Male Sex ◽  
Reported Data ◽  
Axial Involvement

Reported data of axial involvement in psoriatic arthritis (PsA) are variable (25–70%). This variability is mainly linked to different ways of defining this feature. Gladman1 established that the prevalence of axial involvement in PsA was close to 50% and that it is associated with HLA-B27. Likewise, psoriasis (PsO) spondylitis, unlike ankylosing spondylitis (AS), is characterized by not having a greater preponderance of the male sex, greater skin involvement, and a less severe course.2

Diagnosis, classification, and management of peripheral spondyloarthritis

2016 ◽  
Author(s):  
Martin Rudwaleit ◽  
Atul Deodhar
Keyword(s):  
Bacterial Infections ◽  
Axial Skeleton ◽  
Controlled Clinical Trial ◽  
Peripheral Arthritis ◽  
Asas Criteria ◽  
Inflammatory Bowel ◽  
Peripheral Spondyloarthritis ◽  
Chronic Course ◽  
Diagnosis Classification ◽  
Better Than

Spondyloarthritis (SpA) can affect the axial skeleton (axSpA) but also manifest as peripheral arthritis, enthesitis, and dactylitis (peripheral SpA). Peripheral SpA can occur after bacterial infections (reactive arthritis) or be associated with psoriasis or inflammatory bowel disease. The arthritis is usually asymmetric, affects predominantly the lower extremity, and can be self-limiting but can also run a chronic course. The frequency of HLA-B27 is around 50% in purely peripheral SpA, while it is 70–90% in axSpA. For classification, the Amor, ESSG, or more recent ASAS criteria for peripheral SpA can be used. The ASAS criteria are likely to capture early peripheral SpA better than the other two. Therapy includes NSAIDs, local steroid injections, and synthetic disease-modifying antirheumatic drugs, of which sulfasalazine is best studied and the preferred drug for peripheral arthritis. A recent, placebo-controlled clinical trial with adalimumab may lead to the first approval of a biologic in peripheral SpA.

scholarly journals Axial and peripheral spondyloarthritis triggered by sars-cov-2 infection: a report of two cases

Reumatismo ◽  
2021 ◽  
Vol 73 (1) ◽  
pp. 59-63
Author(s):  
G. El Hasbani ◽  
A. Jawad ◽  
I. Uthman
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
The Other ◽  
Musculoskeletal Symptoms ◽  
Hla B27 ◽  
Peripheral Arthritis ◽  
Peripheral Spondyloarthritis

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can show musculoskeletal symptoms such as peripheral arthritis. In rare cases, peripheral arthritis can develop after the resolution of SARS-CoV-2. We present two cases of spondyloarthritis induced by SARS-CoV-2; one case with axial and peripheral spondyloarthritis and the other with peripheral spondyloarthritis. Both cases refer to Lebanese patients who were HLA-B27 positive. These two cases highlight the possible predisposition of HLA-B27 positive patients to the development of spondyloarthritis symptoms triggered by SARS-CoV-2.

scholarly journals Spondyloarthritis and Strength Training: A 4-Year Report

2021 ◽  
Vol 6 (3) ◽  
pp. 58
Author(s):  
Roberto Cannataro ◽  
Lorenzo Di Maio ◽  
Andrea Malorgio ◽  
Matteo Levi Micheli ◽  
Erika Cione
Keyword(s):  
Gold Standard ◽  
Biological Therapy ◽  
Nutritional Intervention ◽  
Peripheral Arthritis ◽  
Biological Drug ◽  
Intervention Plan ◽  
Motor Difficulties ◽  
Peripheral Spondyloarthritis ◽  
One Year

Peripheral spondyloarthritis (SpA) has predominant peripheral (arthritis, enthesitis, or dactylitis) involvement. The severity of the symptoms can have a significant impact on the quality of life. There is no therapeutic gold standard, and physical exercise, with the opposition of resistance, remains controversial. Herein, we report the case of a woman who, at the age of 50, comes to our center with evident motor difficulties. She was previously diagnosed with SpA and was in therapy with a biological drug (adalimumab) for over one year. The training program and the nutritional intervention plan improved her condition, as pointed out by WOMAC, SQS, RAD-36 questionnaire, and BIA analysis, suspending biological therapy for almost two years. During this period, she achieved in sequence: (i) the Italian master deadlift championship, and (ii) the Italian master powerlifting championship, both for two consecutive years.

Axial involvement in patients with early peripheral spondyloarthritis: a prospective MRI study of sacroiliac joints and spine

2020 ◽  
Vol 80 (1) ◽  
pp. 103-108
Author(s):  
Thomas Renson ◽  
Philippe Carron ◽  
Ann-Sophie De Craemer ◽  
Liselotte Deroo ◽  
Manouk de Hooge ◽  
...  
Keyword(s):  
Clinical Remission ◽  
Treatment Withdrawal ◽  
Sacroiliac Joints ◽  
High Prevalence ◽  
Peripheral Spondyloarthritis ◽  
Research Consortium ◽  
Definition Of ◽  
Mri Study ◽  
Necrosis Factor ◽  
Axial Involvement

ObjectivesTo assess axial involvement on MRI in early peripheral spondyloarthritis (pSpA) and to evaluate whether axial inflammation predicts relapse on treatment withdrawal.MethodsFifty-six patients with early, active, newly diagnosed pSpA underwent MRI of the sacroiliac joints (SIJs) and spine prior to golimumab initiation. At sustained clinical remission of pSpA, treatment was withdrawn and a second MRI was performed. Bone marrow oedema (BME) was scored by three readers according to the Spondyloarthritis Research Consortium of Canada (SPARCC) method. Scores were compared with an axial spondyloarthritis cohort (Belgian Arthritis and Spondylitis cohort). Structural lesions were assessed using a similar method. Furthermore, fulfilment of the Assessment of Spondyloarthritis International Society (ASAS) definition of a positive MRI for sacroiliitis was assessed. Spinal images were evaluated for BME and structural lesions using the Canada-Denmark MRI spine scoring system by two readers.ResultsThirty-six per cent showed SIJ BME at baseline, all fulfilling the ASAS definition of sacroiliitis. No association with back pain was found. Twenty-one per cent displayed SIJ structural lesions. Spinal BME was limited: the median inflammation scores were low and no patients had ≥5 inflammatory corner lesions. On clinical remission, a significant decrease in SIJ SPARCC scores was detected. On clinical remission, no significant differences in SIJ SPARCC scores were noted between patients relapsing and those maintaining remission after treatment discontinuation.ConclusionIn patients with early pSpA, a surprisingly high prevalence of sacroiliitis on MRI was observed; SPARCC scores decreased significantly on tumour necrosis factor inhibition. Residual inflammation on MRI was not predictive of relapse of peripheral manifestations. No relevant inflammatory spinal involvement was detected. Collectively, our findings suggest a higher inflammatory burden in patients with early pSpA than anticipated.

scholarly journals Ultrasound-Verified Peripheral Arthritis in Patients with HLA-B*35 Positive Spondyloarthritis

Life ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 524
Author(s):  
Daniela Šošo ◽  
Jure Aljinović ◽  
Sanja Lovrić Kojundžić ◽  
Ivanka Marinović ◽  
Esma Čečuk Jeličić ◽  
...  
Keyword(s):  
Power Doppler ◽  
Joint Effusion ◽  
Ultrasound Finding ◽  
Peripheral Arthritis ◽  
Ultrasound Findings ◽  
Axial Form ◽  
Peripheral Spondyloarthritis ◽  
Pain Patients ◽  
Power Doppler Signal

Background: We aimed to investigate possible association between the HLA-B*35 allele and peripheral arthritis, tenosynovitis and enthesitis. Methods: Ultrasound of peripheral joints and tendons was performed in 72 HLA-B*35 positive patients with preliminary diagnosis of undifferentiated axial form of spondyloarthitis and joint and tendon pain. Patients with other known types of axial and peripheral spondyloarthritis were excluded as well as patients with other known types of arthritis. Results: Pathological changes were found in the joints of 33 (46%) patients and on the tendons in 13 (18%) patients. The most common ultrasound findings were joint effusion and synovial proliferation with positive power Doppler signal grade 1. The most common ultrasound finding in patients with painful tendons was tenosynovitis. A higher disease activity and an increased incidence of elevated CRP (≥5 mg/L) were more often observed in the group with positive ultrasound findings. Conclusion: In this study, we showed that the HLA-B*35 allele could be a potential risk factor for developing peripheral arthritis, but not for tenosynovits and enthesitis in patients with the undifferentiated axial form of spondyloarthritis. This result may influence the follow up of these patients, especially since it gives us an opportunity to consider the use of different types of DMARDs in the treatment of these patients.

scholarly journals FRI0341 RISK FACTORS FOR AXIAL INVOLVEMENT IN EARLY PSORIATIC ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 764-765
Author(s):  
E. Gubar ◽  
E. Loginova ◽  
S. Glukhova ◽  
T. Korotaeva
Keyword(s):  
Psoriatic Arthritis ◽  
Skin Lesion ◽  
Early Stage ◽  
Hla B27 ◽  
Peripheral Arthritis ◽  
X Ray ◽  
Male Sex ◽  
Early Psoriatic Arthritis ◽  
Axial Involvement ◽  
Lesion Severity

Background:Axial Involvement in psoriatic arthritis (PsA) is quite common [1]. Predictors of axial involvement at early-stage of disease haven’t been sufficiently studied.Objectives:To identify predictors of axial involvement in PsA patients (pts) at early-stage of disease.Methods:95 patients (pts) (M/F–47/48) with early PsA fulfilling the CASPAR criteria were included. All pts had peripheral arthritis for≤2 years; no inflammatory back pain (IBP) pts were specifically selected. Mean (Me) age 36.5±10.7 yrs, disease duration 12.2±10.3 mo. Pts underwent standard clinical examination of PsA activity. Me disease activity indexes DAS=4.0±1.4, DAS28=4.2±1.1, BASDAI=4.5±1.6; Me pts global disease activity VAS 56.9±17.1. All patients were evaluated for the presence of IBP by ASAS criteria, underwent sacroiliac joints (SIJs) X-ray (pelvic radiographs) and HLA B27 antigen status study. MRI of SIJs was performed in 79 pts, regardless of IBP presence, on Signa Ovation 0.35T. Radiographic sacroiliitis (R-SI) was identified according to New York criteria (unilateral grade≥3 or bilateral grade≥2). Bone marrow edema/ osteitis on MRI (STIR) was considered active MRI sacroiliitis (MRI-SI). X-ray and MRI results were evaluated by an independent reader. IBP was observed in 63 (66.3%) cases, MRI-SI in 28 of 79 (35.4%) examined cases, R-SI in 29 (30.5%) cases. Skin lesion severity was evaluated as body surface area (BSA) affected: minor at <3%, mild at 3-10%, severe at >10%. Pts were split into 2 groups (gr.): those with axial involvement (axPsA), that is with IBP and/or R-SI and/or MRI-SI; and those without axial involvement (having only peripheral PsA [pPsA]).The axPsA gr. included 65 (68.4%) cases, the pPsA gr. 30 (31.6%) cases. Multi-dimensional step-by-step discriminant analysis was used to identify a group of features that are more typical for the axPsA patients.Results:The following features proved to be the most informative: male sex (р = 0.300), presence of HLA B27 (р = 0.107), mild or high DAS (р = 0.098), skin lesion severity BSA>3% (р = 0.118), and CRP > 5 mg/L (0.038).Sensitivity of model 79.0%, specificity of model 57.7%. Area under ROC curve 0.756; 95% CI (0.642-0.869).Conclusion:It is a combination of features – male sex, HLA-B27 positivity, mild or high activity of peripheral arthritis according to DAS, CRP > 5 mg/L, and BSA> 3% – that constitutes a clinical predictor for the development of axial involvement in early psoriatic arthritis.References:[1]V. Chandran et al. Curr Opin Rheumatol. 2019;31:329-34Disclosure of Interests:ELENA GUBAR: None declared, Elena Loginova Speakers bureau: Janssen, Svetlana Glukhova: None declared, Tatiana Korotaeva Grant/research support from: Pfizer, Consultant of: Abbvie, BIOCAD, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Novartis-Sandoz, Pfizer, UCB, Speakers bureau: Abbvie, BIOCAD, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Novartis-Sandoz, Pfizer, UCB

Performance of the Assessment in Spondyloarthritis International Society Classification for Axial and Peripheral Spondyloarthritis in an Established Clinical Cohort: Comparison with Criteria Sets of Amor and the European Spondylarthropathy Study Group

2012 ◽  
Vol 39 (4) ◽  
pp. 816-821 ◽  
Author(s):  
PETER P. CHEUNG ◽  
SIMON PATERNOTTE ◽  
VINCENT BURKI ◽  
ANNE DURNEZ ◽  
MURIEL ELHAI ◽  
...  
Keyword(s):  
International Society ◽  
Inflammatory Back Pain ◽  
Study Group ◽  
C Reactive Protein ◽  
Peripheral Arthritis ◽  
Protein Levels ◽  
Reactive Protein ◽  
Asas Criteria ◽  
Established Disease ◽  
Peripheral Spondyloarthritis

Objective.To evaluate the performance of the Assessment in Spondyloarthritis International Society (ASAS) criteria (axial or peripheral) against the Amor and European Spondylarthropathy Study Group criteria in established spondyloarthritis (SpA).Methods.Rheumatologist-diagnosed patients with SpA were retrospectively classified according to the different criteria sets. Clinical characteristics of patients fulfilling all 3 criteria were compared with those who did not, by nonparametric statistics.Results.ASAS classified 90% of the 231 patients, with 169 (73%) fulfilling all 3 criteria sets. Multivariate analysis showed the 62 patients not fulfilling all criteria sets were older at symptom onset (p < 0.001) and less likely to have inflammatory back pain (p < 0.001), peripheral arthritis (p < 0.001), or elevated C-reactive protein levels (p = 0.034).Conclusion.ASAS criteria can be used in established disease.

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