Peripheral disease contributes significantly to the level of disease activity in axial spondyloarthritis

Objective Spondyloarthritis (SpA) can encompass axial, peripheral and extra-articular disease manifestations. Patients are classified as axial or peripheral SpA depending on the presence or absence of current back pain, independently of the other disease manifestations. Therefore, we aimed to assess...

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Main Authors: Janneke J de Winter, Jacqueline E Paramarta, Henriëtte M de Jong, Marleen G van de Sande, Dominique L Baeten
Format: Article
Language:English
Published: BMJ Publishing Group 2019-06-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/5/1/e000802.full
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author Janneke J de Winter
Jacqueline E Paramarta
Henriëtte M de Jong
Marleen G van de Sande
Dominique L Baeten
author_facet Janneke J de Winter
Jacqueline E Paramarta
Henriëtte M de Jong
Marleen G van de Sande
Dominique L Baeten
author_sort Janneke J de Winter
collection DOAJ
description Objective Spondyloarthritis (SpA) can encompass axial, peripheral and extra-articular disease manifestations. Patients are classified as axial or peripheral SpA depending on the presence or absence of current back pain, independently of the other disease manifestations. Therefore, we aimed to assess the percentage of patients with axial SpA with peripheral disease and how this peripheral disease contributes to the overall disease activity.Methods Prevalence and disease activity of peripheral disease manifestations were assessed in a real-life observational cohort of 314 patients with the clinical diagnosis of SpA and fulfilling the Assessment of SpondyloArthritis international Society (ASAS) criteria.Results Of the 314 patients fulfilling the ASAS criteria, 230 fulfilled the axial and 84 the peripheral SpA criteria. Of the 230 patients with axial SpA, 49% had purely axial disease without peripheral disease manifestations whereas 51% had combined axial (back pain) and peripheral (arthritis, enthesitis and/or dactylitis) disease. The latter group had the highest disease activity in comparison with pure axial SpA as well as with peripheral SpA.Conclusion Half of the patients classified as axial SpA according to the ASAS criteria also have peripheral disease manifestations such as arthritis, enthesitis and/or dactylitis. These peripheral disease manifestations contribute significantly to overall disease activity.
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spelling doaj-art-cd85faa4b4a44b5a81751e5a597779712025-08-20T03:25:25ZengBMJ Publishing GroupRMD Open2056-59332019-06-015110.1136/rmdopen-2018-000802Peripheral disease contributes significantly to the level of disease activity in axial spondyloarthritisJanneke J de Winter0Jacqueline E Paramarta1Henriëtte M de Jong2Marleen G van de Sande3Dominique L Baeten4Amsterdam Rheumatology and Immunology Center, Department of Clinical Immunology and Rheumatology, Amsterdam UMC University of Amsterdam, Amsterdam, The NetherlandsAmsterdam Rheumatology and Immunology Center, Department of Clinical Immunology and Rheumatology, Amsterdam UMC University of Amsterdam, Amsterdam, The NetherlandsAmsterdam Rheumatology and Immunology Center, Department of Clinical Immunology and Rheumatology, Amsterdam UMC University of Amsterdam, Amsterdam, The NetherlandsAmsterdam Rheumatology and Immunology Center, Department of Clinical Immunology and Rheumatology, Amsterdam UMC University of Amsterdam, Amsterdam, The NetherlandsAmsterdam Rheumatology and Immunology Center, Department of Clinical Immunology and Rheumatology, Amsterdam UMC University of Amsterdam, Amsterdam, The NetherlandsObjective Spondyloarthritis (SpA) can encompass axial, peripheral and extra-articular disease manifestations. Patients are classified as axial or peripheral SpA depending on the presence or absence of current back pain, independently of the other disease manifestations. Therefore, we aimed to assess the percentage of patients with axial SpA with peripheral disease and how this peripheral disease contributes to the overall disease activity.Methods Prevalence and disease activity of peripheral disease manifestations were assessed in a real-life observational cohort of 314 patients with the clinical diagnosis of SpA and fulfilling the Assessment of SpondyloArthritis international Society (ASAS) criteria.Results Of the 314 patients fulfilling the ASAS criteria, 230 fulfilled the axial and 84 the peripheral SpA criteria. Of the 230 patients with axial SpA, 49% had purely axial disease without peripheral disease manifestations whereas 51% had combined axial (back pain) and peripheral (arthritis, enthesitis and/or dactylitis) disease. The latter group had the highest disease activity in comparison with pure axial SpA as well as with peripheral SpA.Conclusion Half of the patients classified as axial SpA according to the ASAS criteria also have peripheral disease manifestations such as arthritis, enthesitis and/or dactylitis. These peripheral disease manifestations contribute significantly to overall disease activity.https://rmdopen.bmj.com/content/5/1/e000802.full
spellingShingle Janneke J de Winter
Jacqueline E Paramarta
Henriëtte M de Jong
Marleen G van de Sande
Dominique L Baeten
Peripheral disease contributes significantly to the level of disease activity in axial spondyloarthritis
RMD Open
title Peripheral disease contributes significantly to the level of disease activity in axial spondyloarthritis
title_full Peripheral disease contributes significantly to the level of disease activity in axial spondyloarthritis
title_fullStr Peripheral disease contributes significantly to the level of disease activity in axial spondyloarthritis
title_full_unstemmed Peripheral disease contributes significantly to the level of disease activity in axial spondyloarthritis
title_short Peripheral disease contributes significantly to the level of disease activity in axial spondyloarthritis
title_sort peripheral disease contributes significantly to the level of disease activity in axial spondyloarthritis
url https://rmdopen.bmj.com/content/5/1/e000802.full
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AT henriettemdejong peripheraldiseasecontributessignificantlytothelevelofdiseaseactivityinaxialspondyloarthritis
AT marleengvandesande peripheraldiseasecontributessignificantlytothelevelofdiseaseactivityinaxialspondyloarthritis
AT dominiquelbaeten peripheraldiseasecontributessignificantlytothelevelofdiseaseactivityinaxialspondyloarthritis