Peripheral spondyloarthritis: a neglected entity-state of the art

RMD Open. 2020 May;6(1):e001136. doi: 10.1136/rmdopen-2019-001136.

Abstract

Peripheral spondyloarthritis (pSpA) refers to a number of seemingly different spondyloarthritis subsets in which psoriatic arthritis (PsA) is the most common, and symptoms of arthritis, enthesitis or dactylitis predominate the clinical presentation. Although formal classification criteria for pSpA have been introduced in 2011, only a minority of epidemiological and clinical studies addressed this clinical entity as a separate disease. Moreover, research on outcome measures and treatment modalities in pSpA has been mainly focused on PsA. Subsequently, all biological treatments are off-label in patients with non-psoriatic pSpA. Its neglected status has important implications for clinical practice since the emerging group of early-diagnosed non-psoriatic pSpA patients remains poorly characterised and lacks specific treatment recommendations. This review summarises what is currently known regarding pSpA in terms of epidemiology, clinical presentation, diagnosis and therapeutic approach.

Keywords: Ankylosing spondylitis; Anti-TNF; Magnetic resonance imaging; Rheumatoid arthritis; Spondyloarthritis.

Publication types

  • Review

MeSH terms

  • Antirheumatic Agents / therapeutic use
  • Biological Products / therapeutic use
  • Diagnostic Imaging
  • HLA-B27 Antigen / genetics
  • Humans
  • Randomized Controlled Trials as Topic
  • Spondylarthritis / classification
  • Spondylarthritis / diagnosis*
  • Spondylarthritis / drug therapy*
  • Spondylarthritis / genetics

Substances

  • Antirheumatic Agents
  • Biological Products
  • HLA-B27 Antigen