PMID- 35794290 OWN - NLM STAT- MEDLINE DCOM- 20220922 LR - 20220922 IS - 1434-9949 (Electronic) IS - 0770-3198 (Linking) VI - 41 IP - 10 DP - 2022 Oct TI - Sacroiliitis at diagnosis as a protective predictor against disease flare after stopping medication: outcomes of a Southeast Asian enthesitis-related arthritis (ERA) longitudinal cohort. PG - 3027-3034 LID - 10.1007/s10067-022-06275-z [doi] AB - OBJECTIVES: To assess short- and long-term outcomes of ERA in a large monocentric cohort in Singapore. METHODS: Children diagnosed with ERA according to ILAR criteria from 2002 to 2021 were recruited. Nonparametric statistics were used to describe the data. Outcomes were defined according to modified Wallace criteria, and probabilities and predictors were determined using Kaplan-Meier survival and logistic regression analyses. RESULTS: One hundred fifty-one ERA patients (male 86%; Chinese 81%) were included. The median age at onset was 11.9 years (IQR: 9.4-13.9), and disease duration was 5.3 years (IQR: 2.9-8.4). At diagnosis, 39% of the patients had sacroiliitis. HLA-B27 was positive in 83%, and biologics were used in 72% of the patients. Clinical inactive disease (CID) was achieved in 92% of the patients, of which 27% achieved within 6 months. Sacroiliitis at diagnosis is an unfavorable predictor of early CID at 6 months. Medication was discontinued in one-third of the patients. Favorable predictor of medication withdrawal includes male gender, while unfavorable predictors include positive HLA-B27 and ANA. Two-thirds of the patients with CID had at least one disease flare. Sacroiliitis at diagnosis is a protective predictor of flare after stopping medication. CONCLUSION: Despite a high proportion of ERA patients achieving CID, only one-third could stop medication with high rates of disease flare. Unfavorable predictors include older age at onset, HLA-B27, and ANA positivity. While sacroiliitis at diagnosis is a negative predictor of CID at 6 months, it is associated with less disease flare after discontinuing medication. CI - (c) 2022. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR). FAU - Teh, Kai Liang AU - Teh KL AD - Rheumatology and Immunology Service, Department of Paediatric Subspecialties, KK Women's and Children's Hospital, Singapore, Singapore. FAU - Das, Lena AU - Das L AD - Rheumatology and Immunology Service, Department of Paediatric Subspecialties, KK Women's and Children's Hospital, Singapore, Singapore. FAU - Book, Yun Xin AU - Book YX AD - Rheumatology and Immunology Service, Department of Paediatric Subspecialties, KK Women's and Children's Hospital, Singapore, Singapore. FAU - Hoh, Sook Fun AU - Hoh SF AD - Division of Nursing, KK Women's and Children's Hospital, Singapore, Singapore. FAU - Gao, Xiaocong AU - Gao X AD - Division of Nursing, KK Women's and Children's Hospital, Singapore, Singapore. FAU - Arkachaisri, Thaschawee AU - Arkachaisri T AUID- ORCID: 0000-0002-1387-1169 AD - Rheumatology and Immunology Service, Department of Paediatric Subspecialties, KK Women's and Children's Hospital, Singapore, Singapore. thaschawee.arkachaisri@singhealth.com.sg. AD - Duke-NUS Medical School, Singapore, Singapore. thaschawee.arkachaisri@singhealth.com.sg. LA - eng PT - Journal Article DEP - 20220706 PL - Germany TA - Clin Rheumatol JT - Clinical rheumatology JID - 8211469 RN - 0 (Biological Products) RN - 0 (HLA-B27 Antigen) SB - IM MH - *Arthritis, Juvenile/drug therapy MH - *Biological Products/therapeutic use MH - Child MH - HLA-B27 Antigen MH - Humans MH - Male MH - *Sacroiliitis/drug therapy MH - Symptom Flare Up OTO - NOTNLM OT - Enthesitis-related arthritis OT - Juvenile idiopathic arthritis OT - Outcomes OT - Predictors OT - Singapore EDAT- 2022/07/07 06:00 MHDA- 2022/09/23 06:00 CRDT- 2022/07/06 23:30 PHST- 2022/06/11 00:00 [received] PHST- 2022/06/29 00:00 [accepted] PHST- 2022/06/27 00:00 [revised] PHST- 2022/07/07 06:00 [pubmed] PHST- 2022/09/23 06:00 [medline] PHST- 2022/07/06 23:30 [entrez] AID - 10.1007/s10067-022-06275-z [pii] AID - 10.1007/s10067-022-06275-z [doi] PST - ppublish SO - Clin Rheumatol. 2022 Oct;41(10):3027-3034. doi: 10.1007/s10067-022-06275-z. Epub 2022 Jul 6.