Current differentiation between radiographic and non-radiographic axial spondyloarthritis is of limited benefit for prediction of important clinical outcomes: data from a large, prospective, observational cohort
| Autor: | Ciurea, Adrian, Kissling, Seraphina, Bürki, Kristina, Baraliakos, Xenofon, de Hooge, Manouk, Hebeisen, Monika, Papagiannoulis, Eleftherios, Exer, Pascale, Bräm, René, Nissen, Michael J, Möller, Burkhard, Kyburz, Diego, Andor, Michael, Distler, Oliver, Scherer, Almut, Micheroli, Raphael |
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| Přispěvatelé: | University of Zurich, Ciurea, Adrian |
| Rok vydání: | 2022 |
| Předmět: |
tumor necrosis factor inhibitors
2745 Rheumatology Immunology SOCIETY 610 Medicine & health Severity of Illness Index DOUBLE-BLIND Rheumatology Spondylarthritis Medicine and Health Sciences ETANERCEPT Immunology and Allergy CRITERIA Humans Spondylitis Ankylosing Prospective Studies 2403 Immunology GRADING SACROILIAC RADIOGRAPHS 10051 Rheumatology Clinic and Institute of Physical Medicine Biology and Life Sciences FACTOR-ALPHA INHIBITION ANKYLOSING-SPONDYLITIS spondylitis EFFICACY ankylosing 2723 Immunology and Allergy Medicine epidemiology 610 Medizin und Gesundheit OBSERVER VARIATION Axial Spondyloarthritis |
| Zdroj: | Ciurea, Adrian; Kissling, Seraphina; Bürki, Kristina; Baraliakos, Xenofon; de Hooge, Manouk; Hebeisen, Monika; Papagiannoulis, Eleftherios; Exer, Pascale; Bräm, René; Nissen, Michael J; Möller, Burkhard; Kyburz, Diego; Andor, Michael; Distler, Oliver; Scherer, Almut; Micheroli, Raphael (2022). Current differentiation between radiographic and non-radiographic axial spondyloarthritis is of limited benefit for prediction of important clinical outcomes: data from a large, prospective, observational cohort. RMD Open, 8(1), e002067. 10.1136/rmdopen-2021-002067 RMD Open, Vol 8, Iss 1 (2022) RMD OPEN |
| ISSN: | 2056-5933 |
| DOI: | 10.5167/uzh-217345 |
| Popis: | ObjectiveTo compare disease characteristics and outcomes between patients with axial spondyloarthritis with non-radiographic disease (nr-axSpA), bilateral grade 2 sacroiliitis (r22axSpA) and unilateral/bilateral grade 3–4 sacroiliitis (r3+axSpA) according to the modified New York criteria.MethodsWe included patients with axial spondyloarthritis with available pelvic radiographs from the Swiss Clinical Quality Management Cohort. Retention of a first tumour necrosis factor inhibitor (TNFi) was investigated with multiple adjusted Cox proportional hazards models. The proportion of patients reaching 50% reduction in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI50) at 1 year was assessed with multiple adjusted logistic regression analyses. Spinal radiographic progression, defined as an increase in ≥2 mSASSS units in 2 years, was assessed in generalised estimating equation models.ResultsFrom 2080 patients, those with nr-axSpA (n=485) and r22axSpA (n=443) presented with lower C reactive protein levels and less severe clinical spinal involvement compared with patients with r3+axSpA (n=1152). While TNFi retention was similar in r22axSpA and nr-axSpA, the risk of discontinuation was significantly lower in r3+axSpA (HR 0.60, 95% CI 0.44 to 0.82 vs nr-axSpA). BASDAI50 responses at 1 year were comparable in r22axSpA and nr-axSpA, with a better response associated with r3+axSpA (OR 2.05, 95% CI 1.09 to 3.91 vs nr-axSpA). Spinal radiographic progression was similar in r22axSpA and nr-axSpA and significantly higher in r3 +axSpA.ConclusionPatients with r22axSpA are comparable to nr-axSpA patients but differ from patients with more severe sacroiliac damage with regard to treatment effectiveness and spinal radiographic progression. Therefore, current differentiation between nr-axSpA and radiographic disease seems of limited use for outcome prediction. |
| Databáze: | OpenAIRE |
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