Anaemia is associated with higher disease activity in axial spondyloarthritis but is not an independent predictor of spinal radiographic progression: data from the Swiss Clinical Quality Management Registry.

Autor: Micheroli R; Department of Rheumatology, Zurich University Hospital, University of Zurich, Gloriastrasse 25, CH-8091, Zurich, Switzerland., Kissling S; Swiss Clinical Quality Management Foundation, Zurich, Switzerland., Bürki K; Department of Rheumatology, Zurich University Hospital, University of Zurich, Gloriastrasse 25, CH-8091, Zurich, Switzerland., Möller B; Department of Rheumatology and Immunology, Inselspital, Bern, Switzerland., Finckh A; Department of Rheumatology, Geneva University Hospital, Geneva, Switzerland., Nissen MJ; Department of Rheumatology, Geneva University Hospital, Geneva, Switzerland., Exer P; Gemeinschaftspraxis Rheuma-Basel, Basel, Switzerland., Bräm R; Swiss Ankylosing Spondylitis Association, Zurich, Switzerland., Kyburz D; Department of Rheumatology, University Hospital Basel, University of Basel, Basel, Switzerland., Rubbert-Roth A; Deparment of Rheumatology, Cantonal Hospital St, Gallen, St. Gallen, Switzerland., Andor M; Rheumatologie Im Zürcher Oberland, Uster, Switzerland., Baraliakos X; Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Bochum, Germany., de Hooge M; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium., Distler O; Department of Rheumatology, Zurich University Hospital, University of Zurich, Gloriastrasse 25, CH-8091, Zurich, Switzerland., Scherer A; Swiss Clinical Quality Management Foundation, Zurich, Switzerland., Ciurea A; Department of Rheumatology, Zurich University Hospital, University of Zurich, Gloriastrasse 25, CH-8091, Zurich, Switzerland. adrian.ciurea@usz.ch.
Jazyk: angličtina
Zdroj: Clinical rheumatology [Clin Rheumatol] 2023 Sep; Vol. 42 (9), pp. 2377-2385. Date of Electronic Publication: 2023 Jun 08.
DOI: 10.1007/s10067-023-06662-0
Abstrakt: Objective: As anaemia represents a biomarker for increased radiographic damage in rheumatoid arthritis, we aimed to investigate whether it independently predicts spinal radiographic progression in axial spondyloarthritis (axSpA).
Methods: AxSpA patients with available haemoglobin levels from the prospective Swiss Clinical Quality Management Registry were included for comparison of patients with and without anaemia. Spinal radiographic progression was assessed according to the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) in patients with ankylosing spondylitis (AS) if ≥ 2 sets of spinal radiographs were available every 2 years. The relationship between anaemia and progression (defined as an increase ≥ 2 mSASSS units in 2 years) was analysed with generalized estimating equation models after adjustment for the Ankylosing Spondylitis Disease Activity Score (ASDAS) and potential confounding, as well as after multiple imputations of missing values.
Results: A total of 212/2522 axSpA patients presented with anaemia (9%). Anaemic patients had higher clinical disease activity, higher acute phase reactants and more severe impairments in physical function, mobility and quality of life. In the subgroup of patients with AS (N = 433), a comparable mSASSS progression was found in anaemic and non-anaemic patients (OR 0.69, 95% CI 0.25 to 1.96, p = 0.49). Age, male sex, baseline radiographic damage and ASDAS were associated with enhanced progression. The results were confirmed in complete case analyses and with progression defined as the formation of ≥ 1 syndesmophyte in 2 years.
Conclusion: Although anaemia was associated with higher disease activity in axSpA, it did not additionally contribute to the prediction of spinal radiographic progression. Key Points • Anaemia is associated with higher disease activity and more severely impaired physical function, mobility and quality of life in axSpA. • Anaemia does not provide an additional value to ASDAS for prediction of spinal radiographic progression.
(© 2023. The Author(s).)
Databáze: MEDLINE
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