Juvenile-Onset Spondyloarthritis

Burgos‐Vargas, Rubén; Tse, Shirley M. L.

doi:10.1016/b978-0-444-63596-9.00002-5

Cited by 2 publications

(3 citation statements)

References 78 publications

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“…There was no correlation with sacroiliitis or HLA-B27. Similar early prevalence was described in a Spanish cohort, where 35% had tarsitis at presentation (47). In this series, the children with tarsitis were much less likely to present with axial pain (8 vs. 54%) or develop axial involvement, and were often initially misdiagnosed with infection.…”

Section: Axial and Peripheral Arthritis And Enthesitis In Jospa/erasupporting

confidence: 84%

Outcomes in Juvenile-Onset Spondyloarthritis

Smith

Burgos‐Vargas

2021

Front. Med.

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Some studies have suggested children with juvenile onset spondyloarthritis (JoSpA) have a relatively poor outcome compared to other juvenile idiopathic arthritis (JIA) categories, in regards to functional status and failure to attain remission. Thus, in the interest of earlier recognition and risk stratification, awareness of the unique characteristics of this group is critical. Herein, we review the clinical burden of disease, prognostic indicators and outcomes in JoSpA. Of note, although children exhibit less axial disease at onset compared to adults with spondyloarthritis (SpA), 34–62% have magnetic resonance imaging (MRI) evidence for active inflammation in the absence of reported back pain. Furthermore, some studies have reported that more than half of children with “enthesitis related arthritis” (ERA) develop axial disease within 5 years of diagnosis. Axial disease, and more specifically sacroiliitis, portends continued active disease. The advent of TNF inhibitors has promised to be a “game changer,” given their relatively high efficacy for enthesitis and axial disease. However, the real world experience in various cohorts since the introduction of more widespread TNF inhibitor usage, in which greater than a third still have persistently active disease, suggests there is still work to be done in developing new therapies and improving the outlook for JoSpA.

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Section: Axial and Peripheral Arthritis And Enthesitis In Jospa/erasupporting

confidence: 84%

Outcomes in Juvenile-Onset Spondyloarthritis

Smith

Burgos‐Vargas

2021

Front. Med.

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“…This finding is related to the natural course of the disease. Spondyloarthritis usually begins in children with peripheral arthritis predominantly involving the lower limbs and/or with peripheral enthesitis rather than axial arthritis [ 1 , 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…Enthesitis/spondylitis-related arthritis (ERA) is a type of juvenile idiopathic arthritis frequently associated with HLA-B27 [ 1 , 2 ]. It’s a chronic inflammatory disease characterized by enthesitis, peripheral arthritis predominantly in the lower limbs and axial arthritis (sacroiliitis and spondylitis) which can progress to ankylosing spondylitis at an advanced stage, occurring before 18 years [ 1 , 2 ]. It is distinguished by male predominance, a strong association with HLA-B27 and the development of anterior uveitis [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Profile of HLA-B27-positive enthesitis/spondylitis-related arthritis in Senegal, West Africa

Sabounji,

Ndiaye,

Diallo

2024

Pediatr Rheumatol

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Background Enthesitis/spondylitis-related arthritis (ERA) is a type of juvenile idiopathic arthritis (JIA) frequently associated with HLA-B27. In sub-Saharan Africa, HLA-B27-positive ERA hasn’t been the subject of a specific study. Objectives We aimed to describe the clinical features, disease activity, functional disability and treatment of HLA-B27-positive ERA at diagnosis in Senegal and compare the findings to other populations. Methods We conducted a retrospective study by reviewing the medical records of patients diagnosed with ERA with an age of symptom onset < 18 years according to the 2019 PRINTO provisional criteria for ERA from January 2012 to December 2022. We collected demographic, clinical, paraclinical and therapeutic data. Disease activity score was assessed by Ankylosing Spondylitis Disease Activity Score (ASDAS) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Functional disability was assessed using Bath Ankylosing Spondylitis Functional Index (BASFI). Results A total of 31 patients with HLA-B27-positive ERA were included. Twenty of 31 (64.5%) were males. Twenty-seven (87%) were Fula (ethnicity). The median age at symptom onset and at diagnosis was 12 years and 19 years, respectively. Seven patients had a family history of Spondyloarthritis. Peripheral arthritis and enthesitis were the most common presenting features at disease onset. Peripheral arthritis was present in 29 (93.5%) and located in the lower limbs in 27/29 (93.1%) patients. Heel enthesitis was present in 26 (83.8%) patients. Axial involvement was present in 27 (87%) patients, dominated by low back pain and sacroiliac pain/ buttock pain in 24 (88.8%) and 22 (81.5%) patients, respectively. Seven (22.5%) patients had anterior uveitis. The ESR and CRP were elevated in 65.5% and 57.1% of cases, respectively. On imaging, sacroiliitis was found in 22 patients. The mean BASDAI was 5.5/10 (77.2% of patients had a high active disease; BASDAI ≥ 4/10). The mean ASDAS-ESR/CRP was 3.8. The mean BASFI was 5.4/10 (80% of patients had high functional disability; BASFI ≥ 4/10). Twenty-seven (87%) patients were treated with methotrexate and non-steroidal anti-inflammatory drugs. After 6 months of treatment, mean BASDAI was 3/10 and mean BASFI was 2.5/10. Conclusion In our study, HLA-B27-positive ERA was found in our Senegalese cohort mainly in adolescents of the Fula ethnic group. 22 (70.9%) patients developed ankylosing spondylitis at adulthood. The disease was very active at the time of diagnosis with significant functional disability. Treatment was mainly based on methotrexate and NAISDs.

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Juvenile-Onset Spondyloarthritis

Cited by 2 publications

References 78 publications

Outcomes in Juvenile-Onset Spondyloarthritis

Outcomes in Juvenile-Onset Spondyloarthritis

Profile of HLA-B27-positive enthesitis/spondylitis-related arthritis in Senegal, West Africa

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