Session Information
Date: Monday, November 9, 2015
Title: Spondylarthropathies and Psoriatic Arthritis - Comorbidities and Treatment Poster II
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Ankylosing spondylitis (AS) is a chronic inflammatory disease that primarily affects the axial skeleton. New bone formation resulting in syndesmophytes can lead to spinal ankylosis and associated disability and poor functional outcomes. Conventional X-rays represent the gold-standard for the assessment of the radiographic damage. In this study, we evaluated a cohort of AS patients to identify factors associated with radiographic progression.
Methods: AS patients (satisfying the modified New York criteria) who had a full set of baseline and follow-up x-rays at a minimum interval of 2 years were included in the study. Two readers scored the X-rays independently. In discordant cases, radiographs were evaluated by an arbitrator. Radiographic damage was assessed by the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Progression was defined as ≥2 mSASSS change between two time points. Clinical variables at baseline were derived from the database and included disease duration, B27 status, demographics, smoking, BASDAI, BASFI, BASMI, SF-36-PCS, -MCS, and ASQoL.
Results: There were 288 patients with a total of 822 x-rays. The mean age and disease duration were 38.7±13.6 and 15.9±10.8 years respectively. 77.1% of the patients were male and 78% were B27 positive. The mean interval between first and last x ray (ΔTime) was 55.9±23.8 months. Total mSASSS change (ΔTotal) was 2.84±6.03 for the cohort overall. The mean mSASSS change/year (ΔYear) was 0.67±1.3 unit. 47.9% of the total patients had damage at baseline as defined as an mSASSS score ≥2. The reliability between the observers regarding lumbar, cervical and total mSASSS scores were 0.97, 0.94 and 0.94 respectively. Overall, 40.6% of the patients progressed during the period of observation. Comparison of progressors vsnon-progressors revealed that age, disease duration, smoking history, baseline radiological damage and baseline BASMI were significantly higher in the patients who progressed (p<0.005). Logistic regression analysis showed that smoking and baseline radiological damage independently predicted the radiographic progression with an odds ratio of 2.8 and 22.8 respectively. In addition to baseline mSASSS, degree of sacroiliitis at baseline was associated with radiographic progression.
Conclusion: AS Patients who are smokers and have baseline changes in SI joints or spine are more likely to demonstrate radiographic progression.
Table 1: Comparison of progressors vs non-progressors
|
|
Non-Progressors (n=171) |
Progressors (n=117) |
P value |
|
Age, years |
34.8±13.5 |
44.4±11.8 |
<0.0001 |
|
Sex, Male, % |
73.7 |
82.1 |
0.11 |
|
Disease duration, years |
13.9±9.9 |
19.1±11.3 |
<0.0001 |
|
B27, % |
79.5 |
75.9 |
0.47 |
|
ΔTime, months |
52.5±20 |
57±25.4 |
0.11 |
|
ΔTotal |
-0.02±0.5 |
7±7.7 |
<0.0001 |
|
ΔYear |
0±0.13 |
1.64±1.6 |
<0.0001 |
|
Right SIJ score |
2.77±0.9 |
3.3±0.9 |
<0.0001 |
|
Left SIJ score |
2.77±0.9 |
3.2±0.9 |
<0.0001 |
|
Hip involvement, % |
9.3 |
10.7 |
0.67 |
|
Baseline damage, % |
28.1 |
76.9 |
<0.0001 |
|
CRP (mg/L) |
12.8±22.1 |
13.2±18.4 |
0.88 |
|
BASDAI |
4.5±2.48 |
4.5±2.45 |
0.86 |
|
BASMI |
1.8±1.9 |
3.6±2.2 |
<0.0001 |
|
SF-PCS |
37.9±11.3 |
37±10.7 |
0.37 |
|
SF-MCS |
47.1±11.5 |
46.1±11.9 |
0.96 |
|
ASQoL |
6.9±5.9 |
7.8±5.8 |
0.36 |
|
Smoking,% |
36.1 |
49.6 |
0.03 |
|
Arthritis, % |
72.9 |
70.9 |
0.8 |
|
Uveitis, % |
30.6 |
40.2 |
0.1 |
|
Psoriasis, % |
18.8 |
19.7 |
0.88 |
|
IBD, % |
14.1 |
17.1 |
0.51 |
Results are given as mean±SD
To cite this abstract in AMA style:
Sari I, Chan J, Omar A, Bedaiwi M, Ayearst R, Inman RD, Haroon N. Factors Predictive of Radiographic Progression in Ankylosing Spondylitis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/factors-predictive-of-radiographic-progression-in-ankylosing-spondylitis/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/factors-predictive-of-radiographic-progression-in-ankylosing-spondylitis/