Enthesitis-related arthritis: monitoring and specific tools

Ferjani, H.; Maatallah, Kaouther; Miri, Sirine; Triki, Wafa; Nessib, Dorra Ben; Kaffel, Dhia; Hamdi, Wafa

doi:10.1016/j.jped.2021.08.002

Cited by 8 publications

(2 citation statements)

References 47 publications

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“…Previous studies reported up to 34-62% of ERA patients with sacroiliitis by MRI regardless of clinical symptoms. Of those, up to 50% develop axial symptoms within 5 years of disease onset, and up to two-thirds develop axial symptoms within 10 years (29)(30)(31).…”

Section: Discussionmentioning

confidence: 99%

Presentation of Enthesitis Related Arthritis and Juvenile-onset Spondyloarthritis, a Cross-sectional Study in a Pediatric and Adult Clinic

Lanças,

Brufatto,

Fernandes

et al. 2024

Preprint

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Background Juvenile idiopathic arthritis (JIA) comprises a whole spectrum of chronic arthritis starting before 16 years of age. The study aims to explore the clinical and demographic descriptors, treatment, and disease progression of enthesitis-related arthritis (ERA) in comparison with juvenile-onset spondyloarthritis (SpA). Methods Cross-sectional analysis of consecutive patients in two dedicated clinics, with one visit and retrospective case-note review. Arthritis, enthesitis and sacroiliitis were evaluated by scoring disease activity and damage. Continuous variables were reported by median, interquartile range; categorical variables were reported by the frequency comparison of the two groups. Results Thirty-three cases, 23 (69.7%) of ERA, were included. The median age at diagnosis was 12.5 y (SpA) vs. 9 y (ERA) (p < 0.01); the time from symptom onset to diagnosis was 5.5 y (SpA) vs. 1.5 y (ERA) (p < 0.03). In both groups, the predominant presentation was a single joint or < 5 lower limb joints and asymmetric involvement, with a high frequency of enthesitis. There was a higher frequency of mid-tarsal and ankle synovitis in the ERA group and hip involvement in those with SpA. The comparison of the frequency of spine symptoms at presentation, 30% SpA vs. 21.7% ERA (p = 0.7), was not significant, and progression to spinal involvement occurred in 43.5% of ERA patients. The median time for spinal progression was 2.3 and 12 y for ERA and SpA, respectively. Activity and damage scores were not significantly different between the groups. Treatment comparison resulted in 91.3% of ERA and 100% SpA being treated, predominantly with NSAIDs in both groups, followed by DMARDs and biologics, with a higher frequency of biologics in SpA. Conclusion The main differences were that SpA had late diagnoses and hip spine involvement, with a higher frequency of biologic treatment, than ERA.

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Section: Discussionmentioning

confidence: 99%

Presentation of Enthesitis Related Arthritis and Juvenile-onset Spondyloarthritis, a Cross-sectional Study in a Pediatric and Adult Clinic

Lanças,

Brufatto,

Fernandes

et al. 2024

Preprint

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“…The MRI remission of sacroiliitis was defined as the lesion of the sacroiliac joint relieved compared with the previous image after treatment for over 6 months. The Juvenile Spondyloarthritis Disease Activity (JSpADA) is a reliable score tool for measuring disease activity in ERA [ 24 ], and it consists of eight items (morning stiffness, patient reported pain, active joints count, active enthesitis count, clinical sacroiliitis, abnormal back mobility, uveitis, and inflammatory biomarkers). JSpADA scores range from 0 to 8, with higher scores indicative of more active disease [ 25 ].…”

Section: Study Design and Participantsmentioning

confidence: 99%

Enthesitis-related arthritis: the clinical characteristics and factors related to MRI remission of sacroiliitis

Zhu

Guo

2022

BMC Musculoskelet Disord

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Background To describe the clinical characteristics and explore the factors related to the MRI remission of sacroiliitis in patients with enthesitis-related arthritis (ERA). Methods Patients with ERA from 2018–2022 in our medical center were retrospectively reviewed, which identified according to Pediatric Rheumatology International Trials Organization (PRINTO) criteria. Demographics, clinical characteristics, examinations, and treatments were described. Univariate and multivariate logistic regression models were used to analyze the factors related to MRI remission of sacroiliitis in ERA. Results This retrospective study included 160 ERA patients (51.9% male) with a mean onset age of 9.2 ± 3.0 years. There were 144 cases (81.9%) with peripheral arthritis, and the hip, knee, and ankle joints were the most commonly involved joints. Enthesitis occurred in 48 cases (30.0%), and sacroiliitis occurred in 142 cases (88.5%) at diagnosis. Human leukocyte antigen (HLA)-B27 was positive in 33 cases (17.1%), and acute uveitis occurred in 3 cases (1.9%). The majority of patients (93.7%) were treated with disease-modifying anti-rheumatic drugs (DMARDs), and 60% with biologics. Among 62 patients with MRI-defined sacroiliitis, 27 (43.5%) cases showed improvement in the sacroiliac joint lesion after treatment. Multivariate logistic regression analysis showed that duration from onset to diagnosis of less than 3 months (OR = 3.609, 95% CI: 1.068–12.192) and active joints of more than 4 (OR = 4.916, 95% CI: 1.006–24.037) were independent factors. Conclusion We highlighted differences in ERA clinical characteristics. Patients with a shorter diagnosis time and more joint involvement improved more significantly in sacroiliac joint lesions after treatment.

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Comment on “Hip involvement in children with enthesitis-related arthritis (ERA) is associated with poor outcomes in adulthood”

2022

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Enthesitis-related arthritis: monitoring and specific tools

Cited by 8 publications

References 47 publications

Presentation of Enthesitis Related Arthritis and Juvenile-onset Spondyloarthritis, a Cross-sectional Study in a Pediatric and Adult Clinic

Presentation of Enthesitis Related Arthritis and Juvenile-onset Spondyloarthritis, a Cross-sectional Study in a Pediatric and Adult Clinic

Enthesitis-related arthritis: the clinical characteristics and factors related to MRI remission of sacroiliitis

Comment on “Hip involvement in children with enthesitis-related arthritis (ERA) is associated with poor outcomes in adulthood”

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