Weiss Pamela F, Brandon Timothy G, Aggarwal Amita, Burgos-Vargas Ruben, Colbert Robert A, Horneff Gerd, Laxer Ronald M, Minden Kirsten, Ravelli Angelo, Ruperto Nicolino, Smith Judith A, Stoll Matthew L, Tse Shirley M, Van den Bosch Filip, Maksymowych Walter P, Lambert Robert G, Biko David M, Chauvin Nancy A, Francavilla Michael L, Jaremko Jacob L, Herregods Nele, Kasapcopur Ozgur, Yildiz Mehmet, Srinivasalu Hemalatha, Hendry Alison M, Joos Rik
Children's Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania.
Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Arthritis Care Res (Hoboken). 2025 Jun;77(6):785-791. doi: 10.1002/acr.25491. Epub 2025 Feb 4.
The Paediatric Rheumatology International Trials Organisation (PRINTO) recently undertook an effort to better harmonize the pediatric and adult arthritis criteria. These provisional criteria are being refined for optimal performance. We aimed to investigate differences between patients who did and did not fulfill these PRINTO criteria among youth diagnosed with juvenile spondyloarthritis (SpA) that met axial juvenile SpA (axJSpA) classification criteria.
This was a retrospective cross-sectional sample of youth diagnosed with juvenile SpA who met the axJSpA classification criteria. Demographics, clinical manifestations, and physician and patient-reported outcomes were abstracted from medical records. Magnetic resonance imaging (MRI) scans underwent central imaging review by at least two central raters. Differences between groups were compared using Wilcoxon signed-rank test or chi-square test, as appropriate.
Of 158 patients who met axJSpA criteria, 107 patients (68%) met the PRINTO provisional criteria for enthesitis/spondylitis-related arthritis. A total of 41 patients (26%) did not fulfill any of the three major PRINTO criteria due to lack of peripheral disease manifestations. Demographics, prevalence of inflammatory or structural lesions on MRI, family history of SpA, and duration of pain were not statistically different between those who did and did not meet PRINTO criteria. Those who fulfilled the PRINTO criteria had significantly more peripheral arthritis, enthesitis, and HLA-B27 positivity but reported less sacral/buttock pain.
Phenotypic differences of children with axJSpA between those who were and were not classified by the PRINTO criteria were primarily due to peripheral disease manifestations and HLA-B27 positivity. Modification of the PRINTO provisional criteria may facilitate capture of youth with primarily axial disease.
儿科风湿病国际试验组织（PRINTO）最近致力于更好地统一儿童和成人关节炎标准。这些临时标准正在完善以实现最佳性能。我们旨在调查在符合轴向幼年型脊柱关节炎（axJSpA）分类标准的幼年型脊柱关节炎（SpA）患儿中，符合和不符合这些PRINTO标准的患者之间的差异。
这是一项对符合axJSpA分类标准的幼年型SpA患儿的回顾性横断面样本研究。从病历中提取人口统计学信息、临床表现以及医生和患者报告的结果。磁共振成像（MRI）扫描由至少两名中心评估者进行集中影像审查。根据情况，使用Wilcoxon符号秩检验或卡方检验比较组间差异。
在158例符合axJSpA标准的患者中，107例（68%）符合PRINTO关于附着点炎/脊柱炎相关关节炎的临时标准。共有41例患者（26%）因缺乏外周疾病表现而未满足PRINTO的三项主要标准中的任何一项。在符合和不符合PRINTO标准的患者之间，人口统计学、MRI上炎症或结构病变的患病率、SpA家族史以及疼痛持续时间在统计学上没有差异。符合PRINTO标准的患者外周关节炎、附着点炎和HLA - B27阳性率显著更高，但骶部/臀部疼痛报告较少。
符合和不符合PRINTO标准的axJSpA患儿的表型差异主要归因于外周疾病表现和HLA - B27阳性。修改PRINTO临时标准可能有助于识别主要患有轴向疾病的患儿。
