Do the provisional PRINTO Enthesitis/Spondylitis-Related JIA criteria capture youth with axial spondyloarthritis?

Pamela F. Weiss, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Timothy G. Brandon, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Amita Aggarwal, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Ruben Burgos-Vargas, Hospital General de Mexico Dr Eduardo Ligeaga, Mexico.
Robert A. Colbert, National Institute of Arthritis, Musculoskeletal, and Skin Diseases, National Institutes of Health, Bethesda, MD, USA.
Gerd Horneff, Asklepios Klinik Sankt Augustin, Sankt Augustin, Germany; University Hospital Cologne, Cologne, Germany.
Ronald M. Laxer, University of Toronto, Toronto, ON, Canada; The Hospital for Sick Children, Toronto, ON, Canada; St. Michael's Hospital, Toronto, ON, Canada.
Kirsten Minden, Charité - Universitätsmedizin Berlin, Germany; Deutsches Rheuma-Forschungszentrum, Berlin, Germany.
Angelo Ravelli, IRCCS Istituto Giannina Gaslini, Genoa, Italy; Università degli Studi di Genova, Genoa, Italy.
Nicolino Ruperto, Università Milano Bicocca, Milano, Italy; IRCCS Fondazione San Gerardo dei Tintori, Monza, Italy.
Judith A. Smith, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.
Matthew L. Stoll, University of Alabama at Birmingham; Birmingham, AL, USA.
Shirley M. Tse, The Hospital for Sick Children (SickKids), University of Toronto, Toronto, ON, Canada.
Filip Van den Bosch, VIB-UGent Center for Inflammation Research, Ghent, Belgium; Ghent University Hospital, Ghent, Belgium.
Walter P. Maksymowych, University of Alberta, Edmonton, AB, Canada; CARE Arthritis, Edmonton, AB, Canada.
Robert G. Lambert, University of Alberta, Edmonton, AB, Canada.
David M. Biko, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Nancy A. Chauvin, Penn State Health Milton S. Hershey Children's Hospital, Hershey, PA, USA.
Michael L. Francavilla, Whiddon College of Medicine, University of South Alabama, Mobile, AL, USA.
Jacob L. Jaremko, University of Alberta, Edmonton, AB, Canada.
Nele Herregods, Ghent University Hospital, Ghent, Belgium.
Ozgur Kasapcopur, Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Istanbul, Turkey.
Mehmet Yildiz, Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Istanbul, Turkey.
Hemalatha Srinivasalu, Children's National Hospital, George Washington University School of Medicine, Washington, DC, USA; National Institute of Arthritis, Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA.
Alison M. Hendry, Counties Manukau District Health Board, Auckland, New Zealand.
Rik Joos, Gent University Hospital, Gent, Belgium; ZNA, Antwerp, Belgium.

Document Type

Journal Article

Publication Date

12-25-2024

Journal

Arthritis care & research

DOI

10.1002/acr.25491

Abstract

BACKGROUND: The Paediatric Rheumatology International Trials Organisation (PRINTO) recently undertook an effort to better harmonize the pediatric and adult arthritis criteria. These provisional criteria are being refined for optimal performance. We aimed to investigate differences between patients who did and did not fulfill these PRINTO criteria amongst youth diagnosed with juvenile spondyloarthritis (SpA) that met axial juvenile SpA (axJSpA) classification criteria. METHODS: This was a retrospective cross-sectional sample of youth diagnosed with juvenile SpA who met the axJSpA classification criteria. Demographics, clinical manifestations, and physician and patient-reported outcomes were abstracted from medical records. MRI scans underwent central imaging review by at least 2 central raters. Differences between groups were compared using Wilcoxon signed-rank test or chi-square, as appropriate. RESULTS: Of 158 patients that met axJSpA criteria, 107 (68%) met the PRINTO provisional criteria for enthesitis/spondylitis-related arthritis. Forty-one (26%) did not fulfill any of the 3 major PRINTO criteria due to lack of peripheral disease manifestations. Demographics, prevalence of inflammatory or structural lesions on MRI, family history of SpA, and duration of pain were not statistically different between those who did and did not meet PRINTO criteria. Those who fulfilled the PRINTO criteria had significantly more peripheral arthritis, enthesitis, and HLA-B27 positivity but reported less sacral/buttock pain. CONCLUSIONS: Phenotypic differences of children with axJSpA between those who were and were not classified by the PRINTO criteria were primarily due to peripheral disease manifestations and HLA-B27 positivity. Modification of the PRINTO provisional criteria may facilitate capture of youth with primarily axial disease.

Department

Pediatrics

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