Abstract：
To explore the registration of enthesitis among biologic-naïve patients with psoriatic arthritis (PsA) initiating tumour necrosis factor inhibitor (TNFi) treatment across 12 European registries, compare the disease burden and patient-reported outcomes (PROs) between patients with and without enthesitis, and assess the enthesitis treatment response.
Demographics, clinical characteristics, and PROs at first TNFi (TNFi-1) initiation (baseline) were assessed in patients with PsA, diagnosed by a rheumatologist, with versus without assessment of entheses and between those with versus without enthesitis. Enthesitis scores and resolution frequency were identified at follow-up.
Of 10 547 patients in the European Spondyloarthritis (EuroSpA) Research Collaboration Network initiating TNFi, 1357 underwent evaluation for enthesitis. Eight registries included a validated scoring system for enthesitis. At baseline, 874 patients underwent entheses assessment [Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) 485 patients, Spondyloarthritis Research Consortium of Canada (SPARCC) 389 patients]. Enthesitis was detected by MASES in 170/485 (35%, mean score ± sd 3.1 ± 2.4) and by SPARCC in 236/389 (61%, 4 ± 3.4). Achilles enthesitis was most frequent, by both MASES (unilateral/bilateral 28%/9%) and SPARCC (48%/18%). MASES/SPARCC baseline and follow-up scores for TNFi-1 were available for 100/105 patients. Of these, 63 patients (63%) (MASES) and 46 (43.8%) (SPARCC) achieved resolution of enthesitis. The site-specific enthesitis resolution was overall lower at SPARCC sites (peripheral; 63-80%) than at MASES sites (mainly axial; 82-100%) following TNFi-1. Disease activity and PROs were worse in patients with versus without enthesitis.
Entheseal assessments are only registered in a minority of patients with PsA in routine care. When assessed, enthesitis was common, and a substantial proportion demonstrated resolution following treatment with TNFi-1.
Demographics, clinical characteristics, and PROs at first TNFi (TNFi-1) initiation (baseline) were assessed in patients with PsA, diagnosed by a rheumatologist, with versus without assessment of entheses and between those with versus without enthesitis. Enthesitis scores and resolution frequency were identified at follow-up.
Of 10 547 patients in the European Spondyloarthritis (EuroSpA) Research Collaboration Network initiating TNFi, 1357 underwent evaluation for enthesitis. Eight registries included a validated scoring system for enthesitis. At baseline, 874 patients underwent entheses assessment [Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) 485 patients, Spondyloarthritis Research Consortium of Canada (SPARCC) 389 patients]. Enthesitis was detected by MASES in 170/485 (35%, mean score ± sd 3.1 ± 2.4) and by SPARCC in 236/389 (61%, 4 ± 3.4). Achilles enthesitis was most frequent, by both MASES (unilateral/bilateral 28%/9%) and SPARCC (48%/18%). MASES/SPARCC baseline and follow-up scores for TNFi-1 were available for 100/105 patients. Of these, 63 patients (63%) (MASES) and 46 (43.8%) (SPARCC) achieved resolution of enthesitis. The site-specific enthesitis resolution was overall lower at SPARCC sites (peripheral; 63-80%) than at MASES sites (mainly axial; 82-100%) following TNFi-1. Disease activity and PROs were worse in patients with versus without enthesitis.
Entheseal assessments are only registered in a minority of patients with PsA in routine care. When assessed, enthesitis was common, and a substantial proportion demonstrated resolution following treatment with TNFi-1.
摘要：
■为了探索在12个欧洲注册中心开始肿瘤坏死因子抑制剂（TNFi）治疗的牛皮癣关节炎（PsA）生物性初治患者中附着性炎的注册，比较有和没有附着点炎的患者的疾病负担和患者报告的结果（PRO），并评估附着体炎的治疗反应。
■人口统计，临床特征,在PsA患者中评估首次TNFi（TNFi-1）启动（基线）和PROs，由风湿病学家诊断，有与没有评估的结果，以及有与没有附着者之间的评估。在随访中确定了端炎评分和消退频率。
■在启动TNFi的欧洲关节炎（EuroSpA）研究合作网络的10.547名患者中，1357例接受附着体炎评估。八个注册表包括经过验证的附件炎评分系统。在基线,874例患者接受了论文评估[马斯特里赫特强直性脊柱炎端头炎评分（MASES）485例患者，加拿大脊柱关节炎研究协会（SPARCC）389名患者]。MASES在170/485（35%，平均评分±SD3.1±2.4)和236/389的SPARCC(61%，4±3.4)。跟腱附件炎最常见，MASES（单侧/双侧28%/9%）和SPARCC（48%/18%）。100/105例患者可获得MASES/SPARCC基线和TNFi-1随访评分。其中,63例患者（63％）（MASES）和46例（43.8％）（SPARCC）获得了附着性炎的解决。在TNFi-1之后，SPARCC部位（外周；63-80％）的部位特异性附着性炎消退率总体上低于MASES部位（主要是轴向；82-100％）。与没有附着点炎的患者相比，疾病活动性和PRO更差。
■Enthesial评估仅在少数常规护理中的PsA患者中注册。评估时，附着体炎很常见，用TNFi-1治疗后，相当比例的患者表现出消退。
■人口统计，临床特征,在PsA患者中评估首次TNFi（TNFi-1）启动（基线）和PROs，由风湿病学家诊断，有与没有评估的结果，以及有与没有附着者之间的评估。在随访中确定了端炎评分和消退频率。
■在启动TNFi的欧洲关节炎（EuroSpA）研究合作网络的10.547名患者中，1357例接受附着体炎评估。八个注册表包括经过验证的附件炎评分系统。在基线,874例患者接受了论文评估[马斯特里赫特强直性脊柱炎端头炎评分（MASES）485例患者，加拿大脊柱关节炎研究协会（SPARCC）389名患者]。MASES在170/485（35%，平均评分±SD3.1±2.4)和236/389的SPARCC(61%，4±3.4)。跟腱附件炎最常见，MASES（单侧/双侧28%/9%）和SPARCC（48%/18%）。100/105例患者可获得MASES/SPARCC基线和TNFi-1随访评分。其中,63例患者（63％）（MASES）和46例（43.8％）（SPARCC）获得了附着性炎的解决。在TNFi-1之后，SPARCC部位（外周；63-80％）的部位特异性附着性炎消退率总体上低于MASES部位（主要是轴向；82-100％）。与没有附着点炎的患者相比，疾病活动性和PRO更差。
■Enthesial评估仅在少数常规护理中的PsA患者中注册。评估时，附着体炎很常见，用TNFi-1治疗后，相当比例的患者表现出消退。
