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Systemic auto-inflammatory manifestations in patients with spondyloarthritis. | LitMetric

Systemic auto-inflammatory manifestations in patients with spondyloarthritis.

Joint Bone Spine

Department of Allergology, Rheumatology and Clinical Immunology, University Children's Hospital, University of Ljubljana and University Medical Centre Ljubljana, Bohoričeva ulica 20, 1000 Ljubljana, Slovenia; Department of Pediatrics, Faculty of Medicine, University of Ljubljana, Bohoričeva ulica 20, 1000 Ljubljana, Slovenia.

Published: December 2024

AI Article Synopsis

  • The study aims to characterize spondyloarthritis (SpA) patients with systemic auto-inflammatory symptoms, compare SpA features in patients with and without these symptoms, and look at differences between these patients and those with Still's disease (SD).
  • In a retrospective analysis of clinical data, researchers found that while Spondyloarthritis with systemic symptoms (S-SpA) and typical SpA shared some features, S-SpA patients experienced different rates of conditions like tenosynovitis and uveitis compared to typical SpA.
  • Results indicated that S-SpA patients generally had milder systemic symptoms than those with SD, but they still faced distinct challenges, and the treatment response was less effective for systemic symptoms in S

Article Abstract

Objectives: (1) characterizing a group of spondyloarthritis (SpA) patients with systemic auto-inflammatory symptoms (S-SpA); (2) comparing SpA features with and without auto-inflammatory symptoms; (3) comparing the auto-inflammatory features of S-SpA and Still's disease (SD).

Methods: Retrospective observational study. Clinical data of adult and pediatric patients with S-SpA, SD or SpA were collected retrospectively and analyzed.

Results: Forty-one subjects with S-SpA, 39 with SD and 42 with SpA were enrolled. The median latency between systemic and articular manifestations in S-SpA was 4.4 (IQR: 7.2) years. S-SpA and SpA had similar frequency of peripheral arthritis and enthesitis (N.S.), while tenosynovitis was more frequent (P=0.01) and uveitis less frequent (P<0.01) in S-SpA. MRI showed signs of sacroiliac inflammation and damage in both S-SpA and SpA equally (N.S.). S-SpA patients had less corner inflammatory lesions (P<0.05) and inflammation at the facet joints (P<0.01), more interspinous enthesitis (P=0.01) and inter-apophyseal capsulitis (P<0.01). Compared to SD, S-SpA patients had lower-grade fever (P<0.01), less rash (P<0.01) and weight loss (P<0.05), but more pharyngitis (P<0.01), gastrointestinal symptoms (P<0.01) and chest pain (P<0.05). ESR, CRP, WBC, ANC, LDH tested higher in SD (P<0.01). Resolution of systemic symptoms was less frequent in S-SpA than SD on corticosteroid (P<0.01) and methotrexate (P<0.05) treatment. When considering all SD patients, a complete response to corticosteroids in the systemic phase significantly reduced the likelihood of developing SpA (OR=0.06, coefficient -2.87 [CI: -5.0 to -0.8]).

Conclusions: SpA should be actively investigated in patients with auto-inflammatory manifestations, including undifferentiated auto-inflammatory disease and SD.

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Source
http://dx.doi.org/10.1016/j.jbspin.2024.105772DOI Listing

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