{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:40:10Z","timestamp":1790894410384,"version":"4.1.0"},"reference-count":33,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T00:00:00Z","timestamp":1612310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"International League of Association for Rheumatology","award":["ILAR (2011)"],"award-info":[{"award-number":["ILAR (2011)"]}]},{"name":"National Arthritis Foundation of Singapore","award":["2011"],"award-info":[{"award-number":["2011"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective. To describe the clinical characteristics, predictors and treatment of children with Enthesitis Related Arthritis (ERA) in a Singapore longitudinal cohort over 11 years. Methods. ERA patients were recruited from our registry (2009\u20132019). Nonparametric descriptive statistics including median (interquartile range, IQR) were used to describe data. Kaplan\u2013Meier survival and logistic\/Cox regression analyses were used to estimate the probabilities and determine predictors of clinical variables, respectively. The significance level was set at &lt;0.05. Results. One hundred and forty-six ERA patients (87% male, 82% Chinese) were included. Median onset age was 11.9 years (IQR 9.4\u201314.0) and median disease duration was 4.9 years (IQR 2.6\u20138.3). Family history of Human Leukocyte Antigen (HLA)-B27 associated diseases was positive in 7.5%. Acute uveitis occurred in 3.4%. Oligoarthritis was present in 89.7%. Hip, knee and ankle joints were among the most common joints involved. One-fourth had enthesitis at diagnosis (Achilles tendon entheses, 82.9%). Sacroiliitis occurred in 61%. Probabilities of sacroiliitis development were 0.364, 0.448 and 0.578 at 1, 2 and 5 years after onset, respectively. Negative HLA-B27, female, older age at onset and hip arthritis at diagnosis were associated with shorter time for sacroiliitis development (p = 0.001\u20130.049). Methotrexate (MTX) remained the most common disease modifying anti-rheumatic drug (DMARD) used (77.4%). However, 77.9% required anti-TNF (aTNF) therapy secondary to MTX failure. Among MTX-treated sacroiliitis patients, 85.3% failed, requiring aTNF, as compared to 63.2%patients without axial disease. Longer duration to diagnosis (p = 0.038) and MTX use (p = 0.007) predicted aTNF therapy. None had joint deformity. Conclusions. This study underscores differences in ERA clinical characteristics, predictors and treatment responses. Our ERA population had many unique findings but good functional outcomes.<\/jats:p>","DOI":"10.3390\/jcm10040568","type":"journal-article","created":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T20:31:51Z","timestamp":1612384311000},"page":"568","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Enthesitis Related Arthritis in a Longitudinal Southeast Asian Registry: High Prevalence of HLA-B27, Different Sacroiliitis Risk Factors and Less Common Drug-Free Remission"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1387-1169","authenticated-orcid":false,"given":"Thaschawee","family":"Arkachaisri","sequence":"first","affiliation":[{"name":"Rheumatology and Immunology Service, Department of Pediatric Subspecialties, KK Women\u2019s and Children\u2019s Hospital, Singapore 229899, Singapore"},{"name":"Duke-NUS Medical School, Pediatric Academic Clinical Program, Singapore 169857, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai Liang","family":"Teh","sequence":"additional","affiliation":[{"name":"Rheumatology and Immunology Service, Department of Pediatric Subspecialties, KK Women\u2019s and Children\u2019s Hospital, Singapore 229899, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun Xin","family":"Book","sequence":"additional","affiliation":[{"name":"Rheumatology and Immunology Service, Department of Pediatric Subspecialties, KK Women\u2019s and Children\u2019s Hospital, Singapore 229899, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sook Fun","family":"Hoh","sequence":"additional","affiliation":[{"name":"Division of Nursing, KK Women\u2019s and Children\u2019s Hospital, Singapore 229899, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaocong","family":"Gao","sequence":"additional","affiliation":[{"name":"Division of Nursing, KK Women\u2019s and Children\u2019s Hospital, Singapore 229899, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Das","sequence":"additional","affiliation":[{"name":"Rheumatology and Immunology Service, Department of Pediatric Subspecialties, KK Women\u2019s and Children\u2019s Hospital, Singapore 229899, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/S2352-4642(19)30027-6","article-title":"Phenotypic variability and disparities in treatment and outcomes of childhood arthritis throughout the world: An observational cohort study","volume":"3","author":"Consolaro","year":"2019","journal-title":"Lancet Child Adolesc. 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