Cross-sectional analysis of consecutive patients in two dedicated clinics, with a single visit and retrospective case-notes review. Arthritis, enthesitis and sacroiliitis were evaluated by scoring disease activity and damage. Continuous variables were reported by median, interquartile range; categorical variables were reported by the frequency comparison of the two groups.
Thirty-three cases were included, being 23 (69.7%) with ERA. The median age at diagnosis was 12.5 y (SpA) vs. 9 y (ERA) (p < 0.01); the time from symptom onset to diagnosis was 5.5 y (SpA) vs. 1.5 y (ERA) (p < 0.03). In both groups, the predominant presentation was a single joint or < 5 lower limb joints and asymmetric involvement, with a high frequency of enthesitis. There was a higher frequency of mid-tarsal and ankle synovitis in the ERA group and hip involvement in those with SpA. The comparison of the frequency of spine symptoms at presentation, 30% SpA vs. 21.7% ERA (p = 0.7), was not significant, and radiographic progression to spinal involvement occurred in 43.5% of ERA patients. The median time for spinal progression and age at onset was 2.2 and 12 y for ERA, and 4 and 16.5 y for SpA, respectively. Activity and damage scores were not significantly different between the groups. Treatment comparison resulted in 91.3% of ERA and 100% SpA being treated, predominantly with NSAIDs in both groups, followed by DMARDs and biologics, with a higher frequency of biologics in SpA.
The main differences were the late diagnoses of SpA, and the hip and spine involvement, with higher frequency of biologic treatment in juvenile-onset SpA compared to ERA.
方法:对两个专门诊所的连续患者进行横断面分析,进行一次访视和回顾性病例记录审查。关节炎,附着点炎和骶髂关节炎通过疾病活动性和损伤评分进行评估.连续变量按中位数报告,四分位距;通过两组的频率比较报告分类变量。
结果:共33例,ERA为23(69.7%)。诊断时的中位年龄为12.5岁(SpA)与9y(ERA)(p<0.01);从症状发作到诊断的时间为5.5y(SpA)与1.5y(ERA)(p<0.03)。在这两组中,主要表现为单个关节或<5个下肢关节和不对称受累,附着物炎的频率很高。ERA组的中tal和踝关节滑膜炎的发生率更高,而SpA组的髋关节受累的发生率更高。脊柱症状出现频率的比较,30%SpAvs.21.7%的ERA(p=0.7),并不重要,43.5%的ERA患者出现脊柱受累的影像学进展.ERA的脊柱进展和发病年龄的中位时间为2.2和12岁,SpA为4和16.5y,分别。两组之间的活动和损伤评分没有显着差异。治疗比较导致91.3%的ERA和100%的SpA被治疗,两组均以NSAIDs为主,其次是DMARDs和生物制剂,SpA中生物制剂的频率更高。
结论:主要差异是SpA的晚期诊断,髋关节和脊柱受累,与ERA相比,青少年期SpA的生物治疗频率更高。