Spinal Radiographic Progression in Early Axial Spondyloarthritis: Data from the DESIR Cohort

Sofia Ramiro¹, Désirée van der Heijde¹, Rosaline van den Berg², Victoria Navarro-Compán³, Antoine Feydy⁴, Maria-Antonietta d'Agostino⁵, Damien Loeuille⁶, Maxime Dougados⁷, Monique Reijnierse⁸ and Pascal Claudepierre⁹, ¹Rheumatology, Leiden University Medical Center, Leiden, Netherlands, ²Leiden University Medical Center, Leiden, Netherlands, ³Rheumatology, University Hospital La Paz, Madrid, Spain, ⁴Paris Descartes University, Radiology B department, Cochin Hospital, Paris, France, ⁵Rheumatology, Versailles-Saint Quentin en Yvelines University, Boulogne-Billancourt, France, ⁶Rheumatology, Nancy University Hospital, Nancy, France, ⁷Rheumatology Department, Cochin hospital, Paris-Descartes University, Paris, France, ⁸Radiology, Leiden University Medical Center, Leiden, Netherlands, ⁹Rheumatology, Université Paris Est Créteil, Créteil, France

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Outcome measures, radiography and spondylarthritis

Session Information

Date: Tuesday, November 10, 2015

Title: Spondylarthropathies and Psoriatic Arthritis - Clinical Aspects and Treatment: Clinical Aspects, Imaging and Biomarkers

Session Type: ACR Concurrent Abstract Session

Session Time: 4:30PM-6:00PM

Background/Purpose: The development of radiographic damage over time has been investigated in patients with AS, but not yet in early axial spondyloarthritis (axSpA). We have recently shown that the modified Stoke in Ankylosing Spondylitis Spine Score (mSASSS) is the most sensitive and adequate scoring method in (early) axSpA. Our aim was to analyse the development and progression of radiographic damage in the spine in patients with IBP and early axSpA.

Methods: Patients with IBP for <3 years and with a clinical suspicion for axSpA were included in DESIR. Yearly cervical and lumbar radiographs from the first 2 years of follow-up were used in this analysis. Patients with radiographs available allowing the estimation of at least one (1-year or 2-year) progression interval were included in this analysis. Two trained readers independently scored the radiographs according to the mSASSS (0-72). Scores per vertebral corner were averaged between the readers. One-year (M0-M12) and two-year (M0-M24) progression scores were computed. Progression was assessed in each of the different subgroups of patients defined at baseline according to the fulfillment of the ASAS axSpA criteria, imaging arm (modified New York Criteria (mNYC) +/- and MRI positivity (according to the ASAS definition)), clinical arm only (+/- positive CRP). In addition, patients were grouped according to presence of baseline syndesmophytes.

Results: In total, 608 patients (mean age 36.0 (SD 8.8) years, 47% males, 74% fulfilling ASAS axSpA criteria) were included. At baseline, the average mSASSS was 0.36 (1.49). From these patients, 571 one-year mSASSS progression intervals could be obtained and 441 two-year progression intervals. Patients fulfilling the ASAS axSpA criteria had on average 0.29 (1.73) mSASSS-units progression in 2 years, whereas those not fulfilling the criteria showed a progression of 0.06 (1.00) units. Patients fulfilling the imaging arm had a progression of 0.42 (2.21) mSASSS-units per 2 years. Within this subgroup of patients, patients fulfilling the mNYC and with a negative MRI had the highest progression, followed by those mNYC+ and MRI+ and lastly those mNYC- but with MRI+ (Table). Patients fulfilling only the clinical arm of the ASAS criteria had a progression of 0.11 (0.60) mSASSS-units per 2 years. Patients with baseline syndesmophytes (across all subgroups) had a 2-year progression of 1.16 (4.31) mSASSS-units.

Table – Progression of spinal radiographic damage over 2 years (1-year and 2-year intervals)

	Subgroup	1-year mSASSS progression (M0-M12) n=517 mean (SD)	2-year mSASSS progression (M0-M24) n=441 mean (SD)
ASAS criteria	ASAS +	0.11 (1.15), n=366	0.29 (1.73), n=322
ASAS criteria	ASAS –	0.08 (0.69), n=147	0.06 (1.00), n=116
ASAS criteria Imaging arm	MRI+ mNYC+	0.20 (2.11), n=96	0.36 (2.38), n=88
	MRI+ mNYC-	-0.02 (0.26), n=76	0.18 (0.93), n=63
	MRI- mNYC+	0.17 (0.47), n=41	1.02 (3.21), n=34
ASAS criteria Clinical arm	Clinical arm only CRP+	0.05 (0.22), n=20	0.14 (0.50), n=21
ASAS criteria Clinical arm	Clinical arm only CRP-	0.10 (0.59), n=130	0.10 (0.62), n=112
Baseline syndesmophytes	Baseline syndesmophytes +	0.38 (3.15), n=34	1.16 (4.31), n=30
Baseline syndesmophytes	Baseline syndesmophytes –	0.08 (0.68), n=483	0.16 (1.12), n=411

Conclusion: Development of spinal radiographic progression can be captured in a cohort of patients with early axSpA within a 2-year follow-up. Progression is higher in patients fulfilling the mNYC and also in patients with baseline syndesmophytes.

Disclosure: S. Ramiro, None; D. van der Heijde, None; R. van den Berg, None; V. Navarro-Compán, None; A. Feydy, None; M. A. d'Agostino, None; D. Loeuille, None; M. Dougados, None; M. Reijnierse, None; P. Claudepierre, None.

To cite this abstract in AMA style:

Ramiro S, van der Heijde D, van den Berg R, Navarro-Compán V, Feydy A, d'Agostino MA, Loeuille D, Dougados M, Reijnierse M, Claudepierre P. Spinal Radiographic Progression in Early Axial Spondyloarthritis: Data from the DESIR Cohort [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/spinal-radiographic-progression-in-early-axial-spondyloarthritis-data-from-the-desir-cohort/. Accessed .

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