Department of Rheumatology, Mohammed Kassab National Institute of Orthopaedics, Mannouba, Tunisia.
Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.
Expert Rev Clin Immunol. 2022 Jan;18(1):93-99. doi: 10.1080/1744666X.2022.2010547. Epub 2021 Dec 1.
The aim of this study is to compare the clinical features, disease activity and physical impairment, between enthesitis-related arthritis, adult and late-onset spondylarthritis in Tunisian patients.
This study included 190 patients divided into three groups according to their age at the onset of symptoms: ERA (onset of symptoms ≤ 16 years of age), AOSpA (16 < onset of symptoms < 50 years of age) and LOSpA (onset of symptoms ≥ 50 years of age). AOSpA and LOSpA patients fulfilled the ASAS criteria for SpA. Whereas, ERA patients were classified according to the ILAR criteria.
Among 190 patients, 21% had ERA, 70.5% had AOSpA, and 8.5% had LOSpA. There were no differences in gender ratio between ERA and AOSpA groups. Regarding the clinical presentation, ERA and LOSpA groups had more peripheral symptoms than AOSpA in whom the axial manifestation pattern continued throughout the course of the disease. HLA-B27 was more associated with ERA (p = 0,007). Extra-articular manifestations were more observed in the ERA group (p = 0.004). Disease activity, functional status and anthropometric parameters were similar between groups. Nevertheless, health-related quality-of-life assessed by ASQoL and SF-36 scores were better in the AOSpA group but with no significant differences. Regarding the treatment option, methotrexate was widely used in the ERA group (p < 0.001).
ERA is characterized mainly by marked peripheral arthritis, more extra-articular manifestations, and a higher frequency of hip involvement.
本研究旨在比较突尼斯患者中与附着点相关的关节炎、成人和晚发性脊柱关节炎之间的临床特征、疾病活动度和身体损伤。
本研究纳入了 190 名患者，根据症状发作年龄分为三组：ERA（症状发作年龄≤16 岁）、AOSpA（16<症状发作年龄<50 岁）和 LOSpA（症状发作年龄≥50 岁）。AOSpA 和 LOSpA 患者符合 ASAS 制定的 SpA 标准。而 ERA 患者根据 ILAR 标准进行分类。
在 190 名患者中，21%为 ERA，70.5%为 AOSpA，8.5%为 LOSpA。ERA 和 AOSpA 组之间的性别比例无差异。在临床表现方面，与 AOSpA 组相比，ERA 和 LOSpA 组的外周症状更多，而 AOSpA 组的轴向表现模式贯穿疾病全程。HLA-B27 与 ERA 更相关（p=0.007）。ERA 组更常见关节外表现（p=0.004）。疾病活动度、功能状态和人体测量参数在各组之间相似。然而，AOSpA 组的 ASQoL 和 SF-36 评分评估的健康相关生活质量更好，但无统计学差异。在治疗选择方面，甲氨蝶呤在 ERA 组中广泛使用（p<0.001）。
ERA 的特点主要为明显的外周关节炎、更多的关节外表现，以及髋关节受累的频率更高。
