Power Doppler signal at the enthesis and bone erosions are the most discriminative OMERACT ultrasound lesions for SpA: results from the DEUS (Defining Enthesitis on Ultrasound in Spondyloarthritis) multicentre study.

Autor:	Di Matteo A; Rheumatology Unit, Department of Clinical and Molecular Sciences, 'Carlo Urbani' Hospital, Polytechnic University of Marche, Ancona, Italy andrea.dimatteo@hotmail.com.; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK., Smerilli G; Rheumatology Unit, Department of Clinical and Molecular Sciences, 'Carlo Urbani' Hospital, Polytechnic University of Marche, Ancona, Italy., Di Donato S; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK., Liu AR; Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China., Becciolini A; Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy., Camarda F; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Rheumatology Section, University of Palermo, Palermo, Italy., Cazenave T; Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina., Cipolletta E; Rheumatology Unit, Department of Clinical and Molecular Sciences, 'Carlo Urbani' Hospital, Polytechnic University of Marche, Ancona, Italy., Corradini D; Rheumatology Unit, University of Cagliari, Cagliari, Italy., de Agustín JJ; Rheumatology Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain., Destro Castaniti GM; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Rheumatology Section, University of Palermo, Palermo, Italy., Di Donato E; Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy., Di Geso L; Department of Internal Medicine, Provincial Hospital Madonna del Soccorso, San Benedetto del Tronto, Italy., Duran E; Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey., Farisogullari B; Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey., Fornaro M; Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J) Rheumatology Unit, University of Bari, Bari, Italy., Francioso F; Rheumatology Unit, Department of Clinical and Molecular Sciences, 'Carlo Urbani' Hospital, Polytechnic University of Marche, Ancona, Italy., Giorgis P; Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina., Granel A; Rheumatology, Hospital San Roque de Gonnet, La Plata, Buenos Aires, Argentina., Hernández-Díaz C; Rheumatology Department, Hospital Juárez de México, Mexico City, Mexico., Horvath R; Department of Paediatric and Adult Rheumatology, Motol University Hospital, Praha, Czech Republic., Hurnakova J; Department of Paediatric and Adult Rheumatology, Motol University Hospital, Praha, Czech Republic., Jesus D; Rheumatology Department, Leiria Hospital Centre, Pousos, Portugal.; Faculty of Health Sciences, University of Beira Interior, Covilha, Portugal., Karadag O; Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey., Li L; Department of Rheumatology and Immunology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China., Marin J; Rheumatology Unit, Department of Internal Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Martire MV; Rheumatology, Hospital San Roque de Gonnet, La Plata, Buenos Aires, Argentina., Michelena X; Rheumatology Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain., Moscioni E; Rheumatology Unit, Department of Clinical and Molecular Sciences, 'Carlo Urbani' Hospital, Polytechnic University of Marche, Ancona, Italy., Muntean L; Department of Rheumatology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania., Piga M; Rheumatology Unit, University of Cagliari, Cagliari, Italy., Rosemffet M; Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina., Rovisco J; Rheumatology Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal., Sahin D; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK., Salaffi F; Rheumatology Unit, Department of Clinical and Molecular Sciences, 'Carlo Urbani' Hospital, Polytechnic University of Marche, Ancona, Italy., Saraiva L; Rheumatology Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal., Scioscia C; Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J) Rheumatology Unit, University of Bari, Bari, Italy., Tamas MM; Department of Rheumatology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania., Tanimura S; Department of Rheumatology, The Hokkaido Medical Center, Sapporo, Japan., Venetsanopoulou A; Department of Rheumatology, School of Health Sciences, University of Ioannina Faculty of Medicine, Ioannina, Greece., Ventura-Rios L; Division of Rheumatology, National Institute of Rehabilitation Luis Guillermo Ibarra, Ciudad de Mexico, Mexico., Villota O; Division of Rheumatology, Fundación Hospital San Pedro, San Juan de Pasto, Colombia.; Department of Rheumatology, Servicio Integral de Reumatología e Inmunología Doctor Orlando Villota, Pasto, Colombia., Villota-Eraso C; Department of Rheumatology, Servicio Integral de Reumatología e Inmunología Doctor Orlando Villota, Pasto, Colombia., Voulgari PV; Department of Rheumatology, School of Health Sciences, University of Ioannina Faculty of Medicine, Ioannina, Greece., Vukatana G; Rheumatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico di Sant'Orsola, Bologna, Italy., Zacariaz Hereter J; Rheumatology Unit, Department of Internal Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Marzo-Ortega H; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK., Grassi W; Rheumatology Unit, Department of Clinical and Molecular Sciences, 'Carlo Urbani' Hospital, Polytechnic University of Marche, Ancona, Italy., Filippucci E; Rheumatology Unit, Department of Clinical and Molecular Sciences, 'Carlo Urbani' Hospital, Polytechnic University of Marche, Ancona, Italy.
Jazyk:	angličtina
Zdroj:	Annals of the rheumatic diseases [Ann Rheum Dis] 2024 Jun 12; Vol. 83 (7), pp. 847-857. Date of Electronic Publication: 2024 Jun 12.
DOI:	10.1136/ard-2023-225443
Abstrakt:	Objectives: To assess, in spondyloarthritis (SpA), the discriminative value of the Outcome Measures in Rheumatology (OMERACT) ultrasound lesions of enthesitis and their associations with clinical features in this population. Methods: In this multicentre study involving 20 rheumatology centres, clinical and ultrasound examinations of the lower limb large entheses were performed in 413 patients with SpA (axial SpA and psoriatic arthritis) and 282 disease controls (osteoarthritis and fibromyalgia). 'Active enthesitis' was defined as (1) power Doppler (PD) at the enthesis grade ≥1 plus entheseal thickening and/or hypoechoic areas, or (2) PD grade >1 (independent of the presence of entheseal thickening and/or hypoechoic areas). Results: In the univariate analysis, all OMERACT lesions except enthesophytes/calcifications showed a significant association with SpA. PD (OR=8.77, 95% CI 4.40 to 19.20, p<0.001) and bone erosions (OR=4.75, 95% CI 2.43 to 10.10, p<0.001) retained this association in the multivariate analysis. Among the lower limb entheses, only the Achilles tendon was significantly associated with SpA (OR=1.93, 95% CI 1.30 to 2.88, p<0.001) in the multivariate analyses. Active enthesitis showed a significant association with SpA (OR=9.20, 95% CI 4.21 to 23.20, p<0.001), and unlike the individual OMERACT ultrasound lesions it was consistently associated with most clinical measures of SpA disease activity and severity in the regression analyses. Conclusions: This large multicentre study assessed the value of different ultrasound findings of enthesitis in SpA, identifying the most discriminative ultrasound lesions and entheseal sites for SpA. Ultrasound could differentiate between SpA-related enthesitis and other forms of entheseal pathology (ie, mechanical enthesitis), thus improving the assessment of entheseal involvement in SpA. Competing Interests: Competing interests: ADM has received speaking fees from Janssen and has received support for attending meetings by Galapagos outside the submitted work. GS has received speaking fees and support for attending meetings by Novartis outside the submitted work. EC has received speaking fees from Novartis outside the submitted work. EDD has received speaking fees from Novartis and has received support for attending meetings by AbbVie outside the submitted work. MF has received speaking fees from Galapagos, AbbVie, Boehringer Ingelheim, Lilly and GSK and has received support for attending meetings by Pfizer outside the submitted work. XM has received speaking fees from AbbVie, Lilly Novartis, UCB and Janssen and has received support for attending meetings by UCB and Janssen outside the submitted work. MGR has received speaking fees from AbbVie, Raffo and Tecnofarma outside the submitted work. HM-O has received research grants from Janssen, Novartis, Pfizer and UCB and honoraria/speaker fees from AbbVie, Amgen, Eli Lilly, Janssen, Moonlake, Novartis, Pfizer, Takeda and UCB non-relevant to the submitted work. WG has received speaking fees from Accademia di Medicina, Janssen, Angelini Ethos, Galapagos, Biopharma and UVET outside the submitted work. EF has received speaking fees from AbbVie, Amgen, BMS, Janssen, Lilly, Novartis, Pfizer and Union Chimique Belge Pharma outside the submitted work. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ on behalf of EULAR.)
Databáze:	MEDLINE
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