Spondyloarthritis & psoriatic arthritis
Associations of sociodemographic, clinical factors and HLA-B alleles with enthesitis and peripheral arthritis in patients with ankylosing spondylitis
Authors' conclusion
There was a higher prevalence of peripheral musculoskeletal manifestations in women with AS, with significant impact on physical function and greater use of methotrexate or sulfasalazine and TNF inhibitors and enrichment for certain non-HLA-B27 HLA-B alleles.
Study context
- Population
- Patients with ankylosing spondylitis (AS) (radiographic axial SpA) from the Prospective Study of Outcomes in Ankylosing Spondylitis cohortlongitudinal cohort
- Participants
- 1,075 patients
- Exposure
- Patients with vs without peripheral arthritis or enthesitis
- Outcome
- Factors associated with peripheral arthritis and enthesitis, especially Achilles tendonitis and plantar fasciitis
Methodological detailslongitudinal, univariable and multivariable analyses
- Longitudinal
- Univariable and multivariable analyses
Main finding
As reported in the abstract
Factors associated with peripheral arthritis on examination
Peripheral arthritis vs No peripheral arthritisOdds ratio (CI)P value
Psoriasis
1.68(1.11–2.54)
P = 0.001Greater functional impairment
1.72(1.31–2.27)
P < 0.001TNFi use
1.50(1.14–1.97)
P < 0.001MTX/SSZ use
2.25(1.57–3.23)
P < 0.001- Higher erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels
- P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | OR (CI) | P value | |
|---|---|---|---|
| Factors associated with enthesitisEnthesitisvs No enthesitisMale sex | 0.57 (0.43–0.75) | P < 0.001 | |
| Factors associated with enthesitisEnthesitisvs No enthesitisPeripheral arthritis | 2.35 (1.47–3.75) | P < 0.001 | |
| Factors associated with enthesitisEnthesitisvs No enthesitisGreater functional impairment | 1.91 (1.43–2.55) | P < 0.001 | |
| Factors associated with plantar fasciitis and/or Achilles' tendonitis on examinationPlantar fasciitis and/or Achilles' tendonitisvs NeitherMale sex | 0.57 (0.43–0.75) | P < 0.001 | |
| Factors associated with plantar fasciitis and/or Achilles' tendonitis on examinationPlantar fasciitis and/or Achilles' tendonitisvs NeitherTNFi use | 1.48 (1.13–1.93) | P < 0.001 | |
| Factors associated with plantar fasciitis and/or Achilles' tendonitis on examinationPlantar fasciitis and/or Achilles' tendonitisvs NeitherSSZ or MTX use | 1.86 (1.30–2.67) | P < 0.001 | |
| HLA-B alleles in peripheral arthritis on examinationPeripheral arthritisvs No peripheral arthritisHLA-B*15 · marginally increased in frequency | 1.84 (1.05–3.21) | P = 0.03 | |
| HLA-B alleles in peripheral arthritis on examinationPeripheral arthritisvs No peripheral arthritisHLA-B*37 · marginally increased in frequency | 3.00 (1.03–8.74) | P = 0.04 | |
| 0.10.31310Odds ratio (log scale) |
- Factors associated with enthesitis — Higher ESR/CRP levels
- p<0.001
- Factors associated with plantar fasciitis and/or Achilles' tendonitis on examination — Significant functional impairment
- p<0.001
Original publication
Associations of sociodemographic, clinical factors and HLA-B alleles with enthesitis and peripheral arthritis in patients with ankylosing spondylitis. RMD Open. Published 12 March 2025. doi:10.
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