Prevalence and clinical associations of ultrasound-confirmed enthesitis in systemic lupus erythematosus
© The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissionsoup.com..
OBJECTIVES: To assess the prevalence of US-confirmed enthesitis in a cohort of patients with SLE and to analyse the clinical associations to enthesitis during the course of SLE.
METHODS: In a retrospective analysis of the SLE cohort of the Lupus Unit of the Careggi University Hospital, US examinations of SLE patients presenting with tender and/or swollen joints were retrieved to assess the presence of enthesitis. Patients with US-proven enthesitis were compared with SLE controls with tender and/or swollen joints who showed no US evidence of enthesitis. Clinical and laboratory features were compared at disease onset and during follow-up.
RESULTS: A total of 400 patients fulfilling EULAR/ACR classification criteria for SLE were assessed. Of these, 106 underwent articular US examination. Evidence of enthesitis was found in 31/106 (29.2%) patients. Seventy-one patients without US-enthesitis were included as controls; four were excluded due to lack of follow-up data. Laboratory and clinical features were comparable between cases and controls at disease onset. Throughout a median follow-up of 10.0 (interquartile range [IQR] 8.3-23.3) years for cases and 12.4 (IQR 7.2-13.3) years for controls, patients with enthesitis were less likely to develop renal involvement (22.6% vs 46.5%, P = 0.028) and failed B cell depletion more frequently (75.0% vs 0%).
CONCLUSION: In SLE patients with clinically active joints, US-proven enthesitis is a fairly common finding. Enthesitis in SLE could be the hallmark of a distinct disease phenotype with less renal involvement, more arthritis and low response to anti-CD 20 therapy, potentially requiring a tailored treatment.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:62 |
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| Enthalten in: |
Rheumatology (Oxford, England) - 62(2023), 11 vom: 02. Nov., Seite 3619-3626 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Fagni, Filippo [VerfasserIn] |
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| Links: |
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| Themen: |
Biologic therapies |
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| Anmerkungen: |
Date Completed 09.11.2023 Date Revised 14.11.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/rheumatology/kead123 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM354353837 |
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| 245 | 1 | 0 | |a Prevalence and clinical associations of ultrasound-confirmed enthesitis in systemic lupus erythematosus |
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| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a OBJECTIVES: To assess the prevalence of US-confirmed enthesitis in a cohort of patients with SLE and to analyse the clinical associations to enthesitis during the course of SLE | ||
| 520 | |a METHODS: In a retrospective analysis of the SLE cohort of the Lupus Unit of the Careggi University Hospital, US examinations of SLE patients presenting with tender and/or swollen joints were retrieved to assess the presence of enthesitis. Patients with US-proven enthesitis were compared with SLE controls with tender and/or swollen joints who showed no US evidence of enthesitis. Clinical and laboratory features were compared at disease onset and during follow-up | ||
| 520 | |a RESULTS: A total of 400 patients fulfilling EULAR/ACR classification criteria for SLE were assessed. Of these, 106 underwent articular US examination. Evidence of enthesitis was found in 31/106 (29.2%) patients. Seventy-one patients without US-enthesitis were included as controls; four were excluded due to lack of follow-up data. Laboratory and clinical features were comparable between cases and controls at disease onset. Throughout a median follow-up of 10.0 (interquartile range [IQR] 8.3-23.3) years for cases and 12.4 (IQR 7.2-13.3) years for controls, patients with enthesitis were less likely to develop renal involvement (22.6% vs 46.5%, P = 0.028) and failed B cell depletion more frequently (75.0% vs 0%) | ||
| 520 | |a CONCLUSION: In SLE patients with clinically active joints, US-proven enthesitis is a fairly common finding. Enthesitis in SLE could be the hallmark of a distinct disease phenotype with less renal involvement, more arthritis and low response to anti-CD 20 therapy, potentially requiring a tailored treatment | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a SLE and autoimmunity | |
| 650 | 4 | |a biologic therapies | |
| 650 | 4 | |a epidemiology | |
| 650 | 4 | |a inflammation | |
| 650 | 4 | |a ultrasonography | |
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| 700 | 1 | |a Palermo, Adalgisa |e verfasserin |4 aut | |
| 700 | 1 | |a Urban, Maria Letizia |e verfasserin |4 aut | |
| 700 | 1 | |a Mazzotta, Ruggero |e verfasserin |4 aut | |
| 700 | 1 | |a Malandrino, Danilo |e verfasserin |4 aut | |
| 700 | 1 | |a Bello, Federica |e verfasserin |4 aut | |
| 700 | 1 | |a Mattioli, Irene |e verfasserin |4 aut | |
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| 700 | 1 | |a Schett, Georg |e verfasserin |4 aut | |
| 700 | 1 | |a Prisco, Domenico |e verfasserin |4 aut | |
| 700 | 1 | |a Emmi, Giacomo |e verfasserin |4 aut | |
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