© Springer International Publishing Switzerland 2016 121
Y. El Miedany (ed.), Patient Reported Outcome Measures in Rheumatic Diseases,
DOI 10.1007/978-3-319-32851-5_5
Chapter 5
PROMs for Spondyloarthritis
Uta Kiltz , Laure Gossec , Xenofon Baraliakos , and Jürgen Braun
Introduction
Patients with spondyloarthritis ( SpA) constitute a heterogeneous group of rheumatic
diseases with a partially common genetic background, represented by HLA- B27
and IL23 receptor polymorphisms, and rather specifi c clinical features such as
infl ammation and ankylosis of the axial skeleton but also peripheral manifestations
(arthritis or enthesitis) [ 1 ]. In addition, SpA patients often suffer from extra- articular
symptoms such as uveitis, psoriasis, or chronic infl ammatory bowel disease (IBD)
[ 2 ]. The clinical picture and the course of SpA is rather variable. Patients with SpA
may have predominant axial (axSpA) or peripheral disease (pSpA), but mixed forms
occur frequently. The disease course of patients with axSpA is often characterized
by infl ammatory changes in the spine, which may develop into areas of new bone
formation. This pathognomonic process is often associated with pain, functional
disability, restricted mobility, fatigue, and decreased quality of life. The classifi ca-
tion of patients with axSpA includes the classical ankylosing spondylitis (AS) and
non-radiographic axSpA—in case no structural changes are yet present. Furthermore,
psoriatic arthritis (PsA), arthritis related to IBD, reactive arthritis (ReA), and juve-
nile SpA can be differentiated (Table 5.1 ) , but clinical overlaps are not infrequent.
Ankylosing spondylitis has always been considered as the prototype of the SpA
U. Kiltz (*) • J. Braun
Rheumazentrum Ruhrgebiet , Herne , Germany
e-mail: [email protected]
L. Gossec
Department of Rheumatology , AP-HP, Pitié Salpêtrière Hospital, UPMC Univ Paris 06,
Sorbonne Universitées , Paris , France
X. Baraliakos
Rheumazentrum Ruhrgebiet , Herne , Germany
Ruhr-University Bochum , Bochum , Germany