Achilles enthesitis on physical examination leads to worse outcomes after 2 years of follow up in patients with ankylosing spondylitis from REGISPONSER-AS registry

Abstract Background Enthesitis represents one of the most important peripheral musculoskeletal manifestations in patients with axial spondyloarthritis (axSpA). However, studies specifically evaluating Achilles tendon enthesitis and its impact over time are scarce. The objectives of this study were t...

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Main Authors: Clementina López-Medina, M. Ángeles Puche-Larrubia, Raquel Granados, Lourdes Ladehesa-Pineda, Desirée Ruiz-Vilchez, M. Carmen Ábalos-Aguilera, Pilar Font-Ugalde, Eduardo Collantes-Estévez
Format: Article
Language:English
Published: BMC 2023-01-01
Series:Arthritis Research & Therapy
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Online Access:https://doi.org/10.1186/s13075-023-02988-x
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author Clementina López-Medina
M. Ángeles Puche-Larrubia
Raquel Granados
Lourdes Ladehesa-Pineda
Desirée Ruiz-Vilchez
M. Carmen Ábalos-Aguilera
Pilar Font-Ugalde
Eduardo Collantes-Estévez
author_facet Clementina López-Medina
M. Ángeles Puche-Larrubia
Raquel Granados
Lourdes Ladehesa-Pineda
Desirée Ruiz-Vilchez
M. Carmen Ábalos-Aguilera
Pilar Font-Ugalde
Eduardo Collantes-Estévez
author_sort Clementina López-Medina
collection DOAJ
description Abstract Background Enthesitis represents one of the most important peripheral musculoskeletal manifestations in patients with axial spondyloarthritis (axSpA). However, studies specifically evaluating Achilles tendon enthesitis and its impact over time are scarce. The objectives of this study were to evaluate the impact of Achilles’ tendon enthesitis found at baseline during physical examination on the outcome measures after 2 years of follow-up in patients with ankylosing spondylitis (AS). Methods This was an observational and prospective study conducted during 2 years of follow-up in the REGISPONSER-AS registry. Linear regression models adjusted for age, body mass index (BMI), and anti-TNF intake were conducted to evaluate the association between the presence of Achilles enthesitis at baseline and the patient-reported outcome (PRO) scores at baseline. The impact of this feature on PROs over 2 years of follow-up was evaluated using mixed models for repeated measures adjusted for age, BMI, and anti-TNF intake. Results Among the 749 patients included, 46 patients (6.1%) showed Achilles’ tendon enthesitis during physical examination at the baseline study visit. Patients with Achilles enthesitis had an increase in the global VAS score, BASDAI, mBASDAI, ASDAS-CRP, and BASFI scores in comparison with patients without this feature. In addition, the mean global VAS, BASDAI, and ASDAS-CRP scores were significantly higher among patients with Achilles enthesitis over the 2 years of follow-up after adjusting for age, BMI, and current anti-TNF intake. The percentage of patients achieving ASDAS low disease activity (ASDAS < 2.1) after 2 years of follow-up was 15.9% and 31.5% for patients with and without Achilles enthesitis, respectively (p = 0.030). Conclusions In patients with AS, the presence of Achilles’ tendon enthesitis was associated with worse scores on the outcome measures after 2 years of follow-up, leading to a lower probability of achieving low disease activity.
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spelling doaj.art-20e2298d59bf4d9bb8f91ab285e233c22023-01-15T12:17:34ZengBMCArthritis Research & Therapy1478-63622023-01-012511910.1186/s13075-023-02988-xAchilles enthesitis on physical examination leads to worse outcomes after 2 years of follow up in patients with ankylosing spondylitis from REGISPONSER-AS registryClementina López-Medina0M. Ángeles Puche-Larrubia1Raquel Granados2Lourdes Ladehesa-Pineda3Desirée Ruiz-Vilchez4M. Carmen Ábalos-Aguilera5Pilar Font-Ugalde6Eduardo Collantes-Estévez7Department of Rheumatology, Reina Sofia University HospitalDepartment of Rheumatology, Reina Sofia University HospitalDepartment of Rheumatology, Reina Sofia University HospitalDepartment of Rheumatology, Reina Sofia University HospitalDepartment of Rheumatology, Reina Sofia University HospitalDepartment of Rheumatology, Reina Sofia University HospitalMaimonides Biomedical Research Institute of Cordoba (IMIBIC)Maimonides Biomedical Research Institute of Cordoba (IMIBIC)Abstract Background Enthesitis represents one of the most important peripheral musculoskeletal manifestations in patients with axial spondyloarthritis (axSpA). However, studies specifically evaluating Achilles tendon enthesitis and its impact over time are scarce. The objectives of this study were to evaluate the impact of Achilles’ tendon enthesitis found at baseline during physical examination on the outcome measures after 2 years of follow-up in patients with ankylosing spondylitis (AS). Methods This was an observational and prospective study conducted during 2 years of follow-up in the REGISPONSER-AS registry. Linear regression models adjusted for age, body mass index (BMI), and anti-TNF intake were conducted to evaluate the association between the presence of Achilles enthesitis at baseline and the patient-reported outcome (PRO) scores at baseline. The impact of this feature on PROs over 2 years of follow-up was evaluated using mixed models for repeated measures adjusted for age, BMI, and anti-TNF intake. Results Among the 749 patients included, 46 patients (6.1%) showed Achilles’ tendon enthesitis during physical examination at the baseline study visit. Patients with Achilles enthesitis had an increase in the global VAS score, BASDAI, mBASDAI, ASDAS-CRP, and BASFI scores in comparison with patients without this feature. In addition, the mean global VAS, BASDAI, and ASDAS-CRP scores were significantly higher among patients with Achilles enthesitis over the 2 years of follow-up after adjusting for age, BMI, and current anti-TNF intake. The percentage of patients achieving ASDAS low disease activity (ASDAS < 2.1) after 2 years of follow-up was 15.9% and 31.5% for patients with and without Achilles enthesitis, respectively (p = 0.030). Conclusions In patients with AS, the presence of Achilles’ tendon enthesitis was associated with worse scores on the outcome measures after 2 years of follow-up, leading to a lower probability of achieving low disease activity.https://doi.org/10.1186/s13075-023-02988-xAnkylosing spondylitisEnthesitisOutcomes
spellingShingle Clementina López-Medina
M. Ángeles Puche-Larrubia
Raquel Granados
Lourdes Ladehesa-Pineda
Desirée Ruiz-Vilchez
M. Carmen Ábalos-Aguilera
Pilar Font-Ugalde
Eduardo Collantes-Estévez
Achilles enthesitis on physical examination leads to worse outcomes after 2 years of follow up in patients with ankylosing spondylitis from REGISPONSER-AS registry
Arthritis Research & Therapy
Ankylosing spondylitis
Enthesitis
Outcomes
title Achilles enthesitis on physical examination leads to worse outcomes after 2 years of follow up in patients with ankylosing spondylitis from REGISPONSER-AS registry
title_full Achilles enthesitis on physical examination leads to worse outcomes after 2 years of follow up in patients with ankylosing spondylitis from REGISPONSER-AS registry
title_fullStr Achilles enthesitis on physical examination leads to worse outcomes after 2 years of follow up in patients with ankylosing spondylitis from REGISPONSER-AS registry
title_full_unstemmed Achilles enthesitis on physical examination leads to worse outcomes after 2 years of follow up in patients with ankylosing spondylitis from REGISPONSER-AS registry
title_short Achilles enthesitis on physical examination leads to worse outcomes after 2 years of follow up in patients with ankylosing spondylitis from REGISPONSER-AS registry
title_sort achilles enthesitis on physical examination leads to worse outcomes after 2 years of follow up in patients with ankylosing spondylitis from regisponser as registry
topic Ankylosing spondylitis
Enthesitis
Outcomes
url https://doi.org/10.1186/s13075-023-02988-x
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