Abstract：
Juvenile idiopathic arthritis (JIA) comprises a whole spectrum of chronic arthritis starting before 16 years of age. The study aims to explore the clinical and demographic descriptors, treatment, and disease progression of enthesitis-related arthritis (ERA) in comparison with juvenile-onset spondyloarthritis (SpA).
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.
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.
摘要：
背景：幼年特发性关节炎（JIA）包括在16岁之前开始的全部慢性关节炎。该研究旨在探索临床和人口统计学描述符，治疗,与幼年型脊柱关节炎（SpA）相比，附着点炎相关关节炎（ERA）的疾病进展。
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。
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。
