Spondyloarthritis & psoriatic arthritis
Peripheral manifestations in spondyloarthritis: a systematic literature review on their assessment and the effect of biological/targeted synthetic DMARDs
Authors' conclusion
Peripheral manifestations are inconsistently assessed and reported in axSpA trials. While b/tsDMARDs have small-to-moderate effects on peripheral manifestations, these may be underestimated due to not being assessed in the population affected at baseline.
Study context
- Population
- Controlled trials evaluating b/tsDMARDs in axial spondyloarthritis (axSpA)/peripheral SpA (pSpA) (excluding psoriatic arthritis)100 axSpA and 4 pSpA trials
- Comparison
- b/tsDMARDs in axSpA and pSpA trials
- Outcome
- Frequency of assessment/reporting of peripheral arthritis/enthesitis/dactylitis and treatment efficacy of b/tsDMARDs on these peripheral manifestations (standardized mean differences (SMDs) or relative risk)
Methodological detailscontrolled trials of b/tsDMARDs, excluding psoriatic arthritis, records from previous systematic literature review (SLRs) informing ASAS-EULAR recommendations and updated searches
- Controlled trials of b/tsDMARDs
- Excluding psoriatic arthritis
- Records from previous SLRs informing ASAS-EULAR recommendations and updated searches
Main finding
As reported in the abstract
Assessment/reporting of peripheral manifestations in axSpA trials
- Peripheral arthritis assessed (% of studies)
- 54%
- Enthesitis assessed (% of studies)
- 64%
- Dactylitis assessed (% of studies)
- 10%
- When assessed, peripheral arthritis reported (% of studies)
- 69%
- When assessed, enthesitis reported (% of studies)
- 72%
- When assessed, dactylitis reported (% of studies)
- 10%
- Most used instrument, peripheral arthritis: 44-joint count
- 48%
- Most used instrument, enthesitis: Maastricht Ankylosing Spondylitis Enthesitis Score
- 88%
- Most used instrument, dactylitis: digit count
- 40%
Further findings
Efficacy of b/tsDMARDs on peripheral manifestations in axSpA (SMD)
- SMD range; mainly small-to-moderate effects, typically higher in patients with baseline peripheral involvement
- 0.26 to −1.18
Peripheral manifestations in pSpA trials
- SMD range; generally moderate effects
- −0.10 to −1.22
- Always assessed/reported
Original publication
Peripheral manifestations in spondyloarthritis: a systematic literature review on their assessment and the effect of biological/targeted synthetic DMARDs. Rheumatology (Oxford). Published 28 January 2026. doi:10.
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