Clinical Features and Outcome of Patients With Juvenile Spondyloarthropathy in a Tertiary Hospital in the Philippines

Abstract

Objective:

To describe the clinical presentation at diagnosis and identify risk factors affecting outcomes in patients with juvenile spondyloarthropathy (JSpA).

Methods:

This retrospective cohort study reviewed records of patients ≤18 years old diagnosed with JSpA (2008-2023) at a pediatric rheumatology clinic, with at least 2 follow-up visits. Remission was defined as (1) on medication (inactive disease ≥6 months) or (2) off medication (inactive disease ≥12 months).

Results:

Eighty-eight patients were included; 90.9% were male. The mean age of onset was 12.6 years. Peripheral arthritis (77.3%) and enthesitis (39.8%) were common. Sacroiliitis was found in 56.8% at diagnosis. Risk factors associated with sacroiliitis included peripheral arthritis and enthesitis, polyarticular, and hip involvement. Golimumab and etanercept were anti-tumor necrosis factor (TNF) agents frequently used. Clinical remission on and off medication occurred in 33% and 10.2%, respectively.

Conclusion:

The JSpA in this cohort demonstrated substantial disease burden, with frequent axial and peripheral involvement. Although 43.2% of patients achieved clinical remission, sustained remission off medication was observed in only 10.2%, reflecting the chronic disease course. Early diagnosis and optimized treatment strategies remain essential to improve outcomes.