Change in different classes of chronic back pain suspicious of axial spondyloarthritis: a latent transition analysis of the SPACE cohort.

Autor:	Bosch P; Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria.; Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, Netherlands.; Department of Epidemiology, Maastricht University, Maastricht, Netherlands., Sepriano A; Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, Netherlands.; Nova Medical School, Universidade Nova de Lisbona, Lisbon, Portugal., Marques ML; Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, Netherlands.; Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal., van der Heijde D; Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, Netherlands., Landewé R; Amsterdam Rheumatology Center, Amsterdam University Medical Center, Amsterdam, Netherlands.; Department of Rheumatology, Zuyderland Medical Center, Heerlen, Netherlands., van Lunteren M; Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, Netherlands., de Bruin L; Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, Netherlands., de Hooge M; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium., Bastiaenen C; Department of Epidemiology, Maastricht University, Maastricht, Netherlands., Exarchou S; Department of Clinical Sciences Malmö (Rheumatology), Lund University, Malmö, Sweden., Ramonda R; Rheumatology Unit, Department of Medicine - DIMED, University Hospital of Padova, Padova, Italy., Fagerli KM; Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway., van Gaalen FA; Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, Netherlands., Ramiro S; Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, Netherlands sofiaramiro@gmail.com.; Department of Rheumatology, Zuyderland Medical Center, Heerlen, Netherlands.
Jazyk:	angličtina
Zdroj:	RMD open [RMD Open] 2024 Sep 30; Vol. 10 (3). Date of Electronic Publication: 2024 Sep 30.
DOI:	10.1136/rmdopen-2024-004584
Abstrakt:	Objectives: To follow up four previously identified classes 'pure axial spondyloarthritis' (axSpA) ('axial'), 'axSpA with peripheral signs' ('inflammatory back pain+peripheral'), 'axSpA at risk' and 'no spondyloarthritis' ('no SpA'). They reflect the expert-opinion-free construct or 'Gestalt' of chronic back pain suspicious of axSpA. The aim was to assess participants' transitions between these classes over time. Methods: Participants with chronic back pain of ≤2 years duration, suspicious of axSpA from the SPondyloArthritis Caught Early cohort were analysed. Latent class (LCA) and latent transition analysis (LTA) using clinical, laboratory and imaging data at baseline and 2 years were calculated. Conditional and marginal probabilities were obtained, reflecting the probability of a spondyloarthritis feature in a class and the probability of the participant's class membership, respectively. Transitional probabilities were extracted revealing potential switches across classes. The analyses were performed in all participants using imputations for missing data and in participants with full data at baseline and 2 years. Results: Baseline and 2 years LCA models were constructed for 702 participants, resulting in the same four-class model as previously described. LTA revealed only a 3% transition from the 'no SpA' to the 'at-risk' class from baseline to 2 years with all other participants remaining in their initially assigned class. Sensitivity analysis on 384 participants with complete data at both baseline and 2 years showed similar results, underlining the model's robustness. Conclusions: Transitions between the four classes over 2 years were basically inexistent, highlighting the unlikelihood of developing new class-defining features of axSpA after an initial clinical workup. Competing Interests: Competing interests: PB has received travelling grants and adds board fees from Janssen, speaker fees from Janssen and AbbVie and projects grants from Pfizer; AS has received speaking and/or consulting fees from AbbVie, Novartis, UCB and Lilly. DvdH has received consulting fees from AbbVie, Argenx, BMS, Galapagos, Glaxo-Smith-Kline, Janssen, Lilly, Novartis, Pfizer, Takeda, UCB Pharma and is an associate editor of Annals Rheumatic Diseases, editorial board member of Journal of Rheumatology and RMD Open, Advisor Assessment of Axial Spondyloarthritis international Society and director of Imaging Rheumatology bv. RL has received honoraria for lectures and advisory boards from AbbVie, Galapagos, Janssen, Lilly, Novartis, Pfizer and UCB. RL is owner of Rheumatology Consultancy BV. MdH has received consultancy fees of UCB Pharma. SE has received consultancy fees from AbbVie, Amgen, Janssen, Novartis, UCB Pharma, Eli Lilly and research support from UCB Pharma. RR has received travelling grants, consulting and/or speaking fees, Advisory Boards fees from Abbvie, Novartis, Janssen, Lilly, MSD, Pfizer, and UCB. FvG reports research grants from Stichting vrienden van Sole Mio, Stichting ASAS, research grants and consultancy fees from Novartis, research grants from UCB, fees from MSD, consultancy fees from Abb Vie, fees from Bristol Myers Squibb and Eli Lilly, is a full time employee of the LUMC and member of the ASAS EC and the ASAS treasurer. SR has received grants from AbbVie, Galapagos, MSD, Novartis, Pfizer, UCB and consultancy fees from AbbVie, Eli Lilly, Galapagos, Janssen, MSD, Pfizer, UCB, Sanofi. The other authors have not declared any COI. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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