Pierluigi Macchioni1,2, Carlo Salvarani1,2, Niccolò Possemato1,2, Marwin Gutierrez1,2, Walter Grassi1,2, Stefania Gasparini1,2, Carlo Perricone1,2, Fabio Massimo Perrotta1,2, Rosa Daniela Grembiale1,2, Caterina Bruno1,2, Cesare Tripolino1,2, Marcello Govoni1,2, Giovanni Ciancio1,2, Ilaria Farina1,2, Roberta Ramonda1,2, Paola Frallonardo1,2, Francesca Desiati1,2, Raffaele Scarpa1,2, Luisa Costa1,2, Alen Zabotti1,2, Salvatore De Vita1,2, Rita Maria D'Attino1,2, Giuliana Gualberti1,2, Rocco Merolla1,2, Umberto di Luzio Paparatti1,2, Raffaella Aldigeri1,2, Antonio Marchesoni3,4. 1. From the Azienda USL-Institute for Research and Health Care (IRCCS) di Reggio Emilia; Università di Modena e Reggio Emilia, Reggio Emilia, Italy; Division of MSK and Rheumatic Disorders, National Institute of Rehabilitation, Mexico City, Mexico; Rheumatology Unit, Università Politecnica delle Marche Ospedale C. Urbani, Jesi; Rheumatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome; Dipartimento di Medicina e Scienze della salute, Università degli studi del Molise, Campobasso; Rheumatology Research Unit, Dipartimento di Scienze della Salute, Università "Magna Graecia" di Catanzaro, Catanzaro; Rheumatology Unit, Department of Medical Sciences, University of Ferrara; Azienda Ospedaliero-Universitaria S. Anna - Ferrara; Rheumatology Unit, Department of Medicine DIMED, University of Padua, Padua; Day Hospital of Rheumatology, Azienda Socio Sanitaria Territoriale (ASST) Gaetano Pini-Centro Specialistico Ortopedico (CTO), Milan; Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; Rheumatology Clinic, Department of Medical and Biological Sciences, University Hospital "Santa Maria della Misericordia," Udine; AbbVie Srl, Rome; Department of Medicine and Surgery, University of Parma, Parma, Italy. R.M. D'Attino, G. Gualberti, and R. Merolla are employees of AbbVie and may own AbbVie stocks/options. U. di Luzio Paparatti was an employee of AbbVie and may own AbbVie stocks/options. AbbVie participated in the design, study conduct, and financial support for the study, as well as in interpretation of the data, review, and approval of the manuscript. Dr. C. Salvarani has acted as a consultant for AbbVie, MSD, Pfizer Inc, Roche, Celgene, and Novartis. Dr. W. Grassi has received honoraria and speaker fees from AbbVie, Roche, BMS, Pfizer, UCB, and MSD. Dr. M. Gutierrez has attended advisory board meetings, held scientific consultancies, and has obtained consulting fees from AbbVie, UCB Pharma, Esaote SpA, Bristol-Myers Squibb, Novartis, and Merck Sharp & Dohme. 2. P. Macchioni, MD, Azienda USL-IRCCS di Reggio Emilia; C. Salvarani, MD, Azienda USL-IRCCS di Reggio Emilia, and Università di Modena e Reggio Emilia; N. Possemato, MD, Azienda USL-IRCCS di Reggio Emilia; M. Gutierrez, MD, Division of MSK and Rheumatic Disorders, National Institute of Rehabilitation; W. Grassi, MD, Rheumatology Unit, Università Politecnica delle Marche Ospedale C. Urbani; S. Gasparini, MD, Rheumatology Unit, Università Politecnica delle Marche Ospedale C. Urbani; C. Perricone, MD, Rheumatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University; F.M. Perrotta, MD, Dipartimento di Medicina e Scienze della Salute, Università degli studi del Molise; R.D. Grembiale, MD, Rheumatology Research Unit, Dipartimento di Scienze della Salute, Università "Magna Graecia" di Catanzaro; C. Bruno, MD, Rheumatology Research Unit, Dipartimento di Scienze della Salute, Università "Magna Graecia" di Catanzaro; C. Tripolino, MD, Rheumatology Research Unit, Dipartimento di Scienze della Salute, Università "Magna Graecia" di Catanzaro; M. Govoni, MD, Rheumatology Unit, Department of Medical Sciences, University of Ferrara, and Azienda Ospedaliero-Universitaria S. Anna; G. Ciancio, MD, Rheumatology Unit, Department of Medical Sciences, University of Ferrara, and Azienda Ospedaliero-Universitaria S. Anna; I. Farina, MD, Rheumatology Unit, Department of Medical Sciences, University of Ferrara, and Azienda Ospedaliero-Universitaria S. Anna; R. Ramonda, MD, Rheumatology Unit, Department of Medicine DIMED, University of Padua; P. Frallonardo, MD, Rheumatology Unit, Department of Medicine DIMED, University of Padua; F. Desiati, MD, Day Hospital of Rheumatology, ASST Gaetano Pini-CTO; R. Scarpa, MD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Zabotti, MD, Rheumatology Clinic, Department of Medical and Biological Sciences, University Hospital "Santa Maria della Misericordia"; S. De Vita, MD, Rheumatology Clinic, Department of Medical and Biological Sciences, University Hospital "Santa Maria della Misericordia"; R.M. D'Attino, MD, AbbVie Srl; G. Gualberti, PhD, AbbVie Srl; R. Merolla, MD, AbbVie Srl; U. di Luzio Paparatti, MD, AbbVie Srl; R. Aldigeri, BSc, Department of Medicine and Surgery, University of Parma; A. Marchesoni, MD, Day Hospital of Rheumatology, ASST Gaetano Pini-CTO. 3. From the Azienda USL-Institute for Research and Health Care (IRCCS) di Reggio Emilia; Università di Modena e Reggio Emilia, Reggio Emilia, Italy; Division of MSK and Rheumatic Disorders, National Institute of Rehabilitation, Mexico City, Mexico; Rheumatology Unit, Università Politecnica delle Marche Ospedale C. Urbani, Jesi; Rheumatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome; Dipartimento di Medicina e Scienze della salute, Università degli studi del Molise, Campobasso; Rheumatology Research Unit, Dipartimento di Scienze della Salute, Università "Magna Graecia" di Catanzaro, Catanzaro; Rheumatology Unit, Department of Medical Sciences, University of Ferrara; Azienda Ospedaliero-Universitaria S. Anna - Ferrara; Rheumatology Unit, Department of Medicine DIMED, University of Padua, Padua; Day Hospital of Rheumatology, Azienda Socio Sanitaria Territoriale (ASST) Gaetano Pini-Centro Specialistico Ortopedico (CTO), Milan; Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; Rheumatology Clinic, Department of Medical and Biological Sciences, University Hospital "Santa Maria della Misericordia," Udine; AbbVie Srl, Rome; Department of Medicine and Surgery, University of Parma, Parma, Italy. R.M. D'Attino, G. Gualberti, and R. Merolla are employees of AbbVie and may own AbbVie stocks/options. U. di Luzio Paparatti was an employee of AbbVie and may own AbbVie stocks/options. AbbVie participated in the design, study conduct, and financial support for the study, as well as in interpretation of the data, review, and approval of the manuscript. Dr. C. Salvarani has acted as a consultant for AbbVie, MSD, Pfizer Inc, Roche, Celgene, and Novartis. Dr. W. Grassi has received honoraria and speaker fees from AbbVie, Roche, BMS, Pfizer, UCB, and MSD. Dr. M. Gutierrez has attended advisory board meetings, held scientific consultancies, and has obtained consulting fees from AbbVie, UCB Pharma, Esaote SpA, Bristol-Myers Squibb, Novartis, and Merck Sharp & Dohme. Antonio.Marchesoni@asst-pini-cto.it. 4. P. Macchioni, MD, Azienda USL-IRCCS di Reggio Emilia; C. Salvarani, MD, Azienda USL-IRCCS di Reggio Emilia, and Università di Modena e Reggio Emilia; N. Possemato, MD, Azienda USL-IRCCS di Reggio Emilia; M. Gutierrez, MD, Division of MSK and Rheumatic Disorders, National Institute of Rehabilitation; W. Grassi, MD, Rheumatology Unit, Università Politecnica delle Marche Ospedale C. Urbani; S. Gasparini, MD, Rheumatology Unit, Università Politecnica delle Marche Ospedale C. Urbani; C. Perricone, MD, Rheumatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University; F.M. Perrotta, MD, Dipartimento di Medicina e Scienze della Salute, Università degli studi del Molise; R.D. Grembiale, MD, Rheumatology Research Unit, Dipartimento di Scienze della Salute, Università "Magna Graecia" di Catanzaro; C. Bruno, MD, Rheumatology Research Unit, Dipartimento di Scienze della Salute, Università "Magna Graecia" di Catanzaro; C. Tripolino, MD, Rheumatology Research Unit, Dipartimento di Scienze della Salute, Università "Magna Graecia" di Catanzaro; M. Govoni, MD, Rheumatology Unit, Department of Medical Sciences, University of Ferrara, and Azienda Ospedaliero-Universitaria S. Anna; G. Ciancio, MD, Rheumatology Unit, Department of Medical Sciences, University of Ferrara, and Azienda Ospedaliero-Universitaria S. Anna; I. Farina, MD, Rheumatology Unit, Department of Medical Sciences, University of Ferrara, and Azienda Ospedaliero-Universitaria S. Anna; R. Ramonda, MD, Rheumatology Unit, Department of Medicine DIMED, University of Padua; P. Frallonardo, MD, Rheumatology Unit, Department of Medicine DIMED, University of Padua; F. Desiati, MD, Day Hospital of Rheumatology, ASST Gaetano Pini-CTO; R. Scarpa, MD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Zabotti, MD, Rheumatology Clinic, Department of Medical and Biological Sciences, University Hospital "Santa Maria della Misericordia"; S. De Vita, MD, Rheumatology Clinic, Department of Medical and Biological Sciences, University Hospital "Santa Maria della Misericordia"; R.M. D'Attino, MD, AbbVie Srl; G. Gualberti, PhD, AbbVie Srl; R. Merolla, MD, AbbVie Srl; U. di Luzio Paparatti, MD, AbbVie Srl; R. Aldigeri, BSc, Department of Medicine and Surgery, University of Parma; A. Marchesoni, MD, Day Hospital of Rheumatology, ASST Gaetano Pini-CTO. Antonio.Marchesoni@asst-pini-cto.it.
Abstract
OBJECTIVE: The purpose of the ULISSE study was to evaluate the prevalence of clinical and ultrasonographic (US) entheseal involvement in patients with psoriatic arthritis (PsA), psoriasis, and fibromyalgia syndrome (FMS). METHODS: In this cross-sectional multicenter study, patients with PsA and psoriasis (not taking systemic therapy) and FMS underwent a clinical evaluation of the entheses, and a B-mode and power Doppler examination of 6 pairs of entheses. RESULTS: The study analyzed 140 patients with PsA, 51 with psoriasis, and 51 with FMS. Clinical and US examinations were performed in 1960 and 1680 entheses in the PsA group, and 714 and 612 entheses both in the psoriasis group and in the FMS group. In both per-patient and per-enthesis evaluation, the frequency of entheseal tenderness was higher in patients with FMS (92% of the patients and 46% of the entheses, compared with 66%/23% in the PsA group and 59%/18% in the psoriasis group). With US examination, signs of entheseal involvement were more frequent in both the per-patient and per-enthesis evaluation in PsA and psoriasis (about 90% of patients in both the PsA and psoriasis groups and 75% of patients in the FMS group had at least 1 site affected, and 54%, 41%, and 27% of the pairs of entheses in, respectively, PsA, psoriasis, and FMS patients showed at least 1 enthesis involved). CONCLUSION: The ULISSE study indicated that enthesitis is a common feature in patients with PsA, those with psoriasis, and in those with FMS if only clinical examination is used. US entheseal assessment showed findings more consistent with the 3 disorders.
OBJECTIVE: The purpose of the ULISSE study was to evaluate the prevalence of clinical and ultrasonographic (US) entheseal involvement in patients with psoriatic arthritis (PsA), psoriasis, and fibromyalgia syndrome (FMS). METHODS: In this cross-sectional multicenter study, patients with PsA and psoriasis (not taking systemic therapy) and FMS underwent a clinical evaluation of the entheses, and a B-mode and power Doppler examination of 6 pairs of entheses. RESULTS: The study analyzed 140 patients with PsA, 51 with psoriasis, and 51 with FMS. Clinical and US examinations were performed in 1960 and 1680 entheses in the PsA group, and 714 and 612 entheses both in the psoriasis group and in the FMS group. In both per-patient and per-enthesis evaluation, the frequency of entheseal tenderness was higher in patients with FMS (92% of the patients and 46% of the entheses, compared with 66%/23% in the PsA group and 59%/18% in the psoriasis group). With US examination, signs of entheseal involvement were more frequent in both the per-patient and per-enthesis evaluation in PsA and psoriasis (about 90% of patients in both the PsA and psoriasis groups and 75% of patients in the FMS group had at least 1 site affected, and 54%, 41%, and 27% of the pairs of entheses in, respectively, PsA, psoriasis, and FMS patients showed at least 1 enthesis involved). CONCLUSION: The ULISSE study indicated that enthesitis is a common feature in patients with PsA, those with psoriasis, and in those with FMS if only clinical examination is used. US entheseal assessment showed findings more consistent with the 3 disorders.
Authors: Philip J Mease; Dafna D Gladman; Atul Deodhar; Dennis G McGonagle; Peter Nash; Wolf-Henning Boehncke; Alice Gottlieb; Xie L Xu; Stephen Xu; Elizabeth C Hsia; Chetan S Karyekar; Philip S Helliwell Journal: RMD Open Date: 2020-07