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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Arthritis+Res+Ther
2017 ; 19
(1
): 84
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Multicenter inception cohort of enthesitis-related arthritis: variation in
disease characteristics and treatment approaches
#MMPMID28464909
Gmuca S
; Xiao R
; Brandon TG
; Pagnini I
; Wright TB
; Beukelman T
; Morgan EM
; Weiss PF
Arthritis Res Ther
2017[May]; 19
(1
): 84
PMID28464909
show ga
BACKGROUND: Enthesitis-related arthritis (ERA) is a specific subtype of juvenile
idiopathic arthritis (JIA) defined according to the International League of
Associations for Rheumatology (ILAR) criteria. We aimed to characterize the
clinical features and treatment regimens in an inception cohort of children with
ERA. METHODS: We performed a retrospective, cross-sectional, multicenter cohort
study including subjects diagnosed with ERA between 1989 and 2012. Patients all
fulfilled the ILAR criteria for ERA within 3 months of initial presentation to
the rheumatology clinic. Differences in the prevalence of clinical criteria
across study sites and by human leukocyte antigen (HLA)-B27 status were assessed
using the Wilcoxon rank-sum or chi-square test, as appropriate. RESULTS: Two
hundred thirty-four children met the inclusion criteria. Their median age at
diagnosis was 11.6 years, and 59% were HLA-B27-positive. Sixty-nine percent had
enthesitis and arthritis at the time of diagnosis. Seventy-eight percent had a
pauciarticular onset. The prevalence of all ILAR criteria at diagnosis, except
arthritis and acute anterior uveitis, differed significantly across sites (all
p?0.01). Medication use varied significantly across sites for children with
peripheral arthritis (p?0.001), but not for sacroiliitis or enthesitis only.
Nonsteroidal anti-inflammatory drugs and disease-modifying antirheumatic drugs
were the most commonly prescribed treatments, with anti-TNF agents primarily
being initiation for sacroiliitis. HLA-B27 positivity was associated with male
sex, higher active joint count, sacroiliitis, and higher disease activity at
disease onset. CONCLUSIONS: The majority of children had a pauciarticular onset,
and several statistically significant clinical differences based on HLA-B27
status were identified. The observed heterogeneity in clinical presentation
across sites reflects either true differences in patient populations or
differences in how the ILAR criteria are being applied.
|*Internationality
[MESH]
|Adolescent
[MESH]
|Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use
[MESH]