Objective To analyzed the prevalence of enthesitis in patients with spondyloarthritis(SpA)and its response to treatment with biological agents.Methods Clinical data of 560 SpA patients[446 patients in ankylosing spondylitis(AS)group,79 patients in non-radiographic axial spondyloarthritis(nr-axSpaA)group and 35 patients in peripheral spondyloarthritis(pSpA)group]were collected.According to the presence and absence of enthesitis,they were dived into non-enthesitis group(290 cases)and enthesitis group(270cases).194 patients with complete follow-up data for at least 6 months were divided into non-biological agents group(32 cases)and biological agents group(162 cases)according to different treatment methods.Their clinical data were compared respectively.Results The five most common sites of enthesitis were spinous processes of the fifth lumbar spine,right posterior superior iliac crest,left posterior superior iliac crest,left achilles tendon and right achilles tendon.Physician's Global Assessment(PGA),the levels of erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)level,Bath AS Activity Score(BASDAI),CRP-based AS activity score(ASDAScrp)and the proportion of peripheral arthritis patients in enthesitis group were higher than those in non-enthesitis group;the thoracic expansion,lumbar range of motion,BASFI and the proportion of patients with grade Ⅰ-Ⅱ joint function in enthesitis group were lower than those in non-enthesitis group(P＜0.05).Compared with the same group before treatment,MASES and the proportion of patients with enthesitis were lower in non-biological agents group after treatment.The degree of chest expansion was higher in biological agents group after treatment and PGA,CRP,ESR,ASDAScrp,BASDAI,Bath AS Functional Index(BASFI),Maastricht ankylost spondylitis Adhesion Score(MASES),the proportions of patients with enthesitis,peripheral arthritis and Spondyloarthritis research consortium Canada(SPARCC)score＞0 point were lower;compared with non-biological agents group,degree of chest expansion in biological agents group was lower during the same period before treatment,CRP and ASDAScrp were lower after treatment(P＜0.05).The multivariate logistic regression analysis showed that elevated ASDAScrp and peripheral arthritis were the risk factors for enthesitis in SpA patients,increased ESR and use of biological agents was the protective factor for enthesitis in SpA patients(P＜0.05).Conclusion Combined enthesitis in SpA patients suggests disease activity,ASDAScrp and combined peripheral arthritis are risk factors for enthesitis in SpA and use of biological agents can reduce the occurrence of enthesitis.
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