末端炎
医学
四分位间距
队列
内科学
回顾性队列研究
脊椎关节病
疾病
银屑病性关节炎
作者
Filippo Fagni,Alessandra Bettiol,Elena Silvestri,Roberto Fedi,Adalgisa Palermo,Maria Letizia Urban,Ruggero Mazzotta,Danilo Malandrino,Federica Bello,Irene Mattioli,David A. Simon,Gerardo Di Scala,Georg Schett,Domenico Prisco,Giacomo Emmi
出处
期刊:Rheumatology
[Oxford University Press]
日期:2023-03-17
卷期号:62 (11): 3619-3626
被引量:1
标识
DOI:10.1093/rheumatology/kead123
摘要
Abstract Objectives To assess the prevalence of US-confirmed enthesitis in a cohort of patients with SLE and to analyse the clinical associations to enthesitis during the course of SLE. Methods In a retrospective analysis of the SLE cohort of the Lupus Unit of the Careggi University Hospital, US examinations of SLE patients presenting with tender and/or swollen joints were retrieved to assess the presence of enthesitis. Patients with US-proven enthesitis were compared with SLE controls with tender and/or swollen joints who showed no US evidence of enthesitis. Clinical and laboratory features were compared at disease onset and during follow-up. Results A total of 400 patients fulfilling EULAR/ACR classification criteria for SLE were assessed. Of these, 106 underwent articular US examination. Evidence of enthesitis was found in 31/106 (29.2%) patients. Seventy-one patients without US-enthesitis were included as controls; four were excluded due to lack of follow-up data. Laboratory and clinical features were comparable between cases and controls at disease onset. Throughout a median follow-up of 10.0 (interquartile range [IQR] 8.3–23.3) years for cases and 12.4 (IQR 7.2–13.3) years for controls, patients with enthesitis were less likely to develop renal involvement (22.6% vs 46.5%, P = 0.028) and failed B cell depletion more frequently (75.0% vs 0%). Conclusion In SLE patients with clinically active joints, US-proven enthesitis is a fairly common finding. Enthesitis in SLE could be the hallmark of a distinct disease phenotype with less renal involvement, more arthritis and low response to anti-CD 20 therapy, potentially requiring a tailored treatment.
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