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.
■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。