ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 0450

Identifying Trajectories of Radiographic Spinal Disease in Ankylosing Spondylitis

Mark Hwang1, Minjae Lee2, Lianne Gensler3, Matthew Brown4, Amirali Tahanan5, Mohammad Rahbar6, Theresa Hunter7, Mingyan Shan8, Mariko Ishimori9, John Reveille10, Michael Weisman11 and Thomas Learch12, 1McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, 2UT Southwestern, Dallas, TX, 3Department of Rheumatology, University of California San Francisco, San Francisco, CA, 4King's College London, London, United Kingdom, 5McGovern Medical School, Houston, TX, 6Division of Clinical and Translational Sciences, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX, 7Eli Lilly and Company, Indianapolis, IN, USA, Indianapolis, IN, 8Eli Lilly and Company, Indianapolis, IN, 9Cedars-Sinai Health System, Los Angeles, CA, 10Division of Rheumatology, The University of Texas Health Science Center at Houston, Houston, TX, 11Adjunct Professor of Medicine, Stanford University; Distinguished Professor of Medicine Emeritus, David Geffen School of Medicine at UCLA, Los Angeles, CA, 12Cedars-Sinai, Los Angeles, CA

Meeting: ACR Convergence 2021

Keywords: , , ,

Session Information

Date: Saturday, November 6, 2021

Title: Abstracts: Spondyloarthritis Including PsA – Diagnosis, Manifestations, & Outcomes I (0449–0452)

Session Type: Abstract Session

Session Time: 9:45AM-10:00AM

Background/Purpose: Little is known about the natural history of spinal disease in Ankylosing Spondylitis (AS). Our objective was to identify distinct patterns of change in vertebral involvement over time and to study associated clinical factors.

Methods: Data were analyzed from the Prospective Study of Outcomes in Ankylosing Spondylitis (PSOAS) cohort. All patients met modified New York Criteria for AS, and had ≥2 sets of radiographs scored by modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) read by local-rheumatologist and central-radiologist between 2002-2017. Group-based trajectory modeling (GBTM) was used to classify patients into distinct groups of longitudinal mSASSS considering sociodemographic and clinical covariables. The optimal trajectory model and number of trajectories was selected using Nagin’s Bayesian information Criteria (BIC) (1).

Results: A total of 561 patients with 1618 radiographs was analyzed (Figure 1). The optimum number of trajectory groups identified was four (BIC -4062). These groups were subsequently categorized as: Non-progressors (204 patients, 37% of total), late-progressors (147, 26%), early-progressors (107, 19%) and rapid-progressors (103, 18%)(Figure 2). Baseline predictors associated with higher spinal disease burden groups included: male, gender, longer disease duration, and smoking history (Table 1.). In addition, elevated time-varying C-reactive protein (eCRP) levels were positively associated with higher disease progression groups and time-varying anti-TNF use was associated with decreased mSASSS progression in the rapid-progressor group.

Conclusion: GBTM identified 4 major patterns of spinal disease progression in the PSOAS cohort. Male gender, longer disease duration, eCRP and smoking were associated with higher spinal disease groups. Independent confirmation in other AS cohorts is needed to confirm these radiographic patterns.

Reference:
1. Nagin, D. Group-Based Modeling of Development. Cambridge: Harvard University Press; 2005

Time in years is along the X-axis and total Modified Stokes Ankylosing Spinal Score is along the Y-axis. Each individual line (n=561) represents a patient in the PSOAS cohort from time in cohort entry with all complete mSASSS scores included with at least 2 sets of radiographs.

Time in years is along the X-axis and total Modified Stokes Ankylosing Spinal Score is along the Y-axis. The solid line represents the estimated mean with dotted lines representing the 95% confidence Interval. Trajectory groups from this patient cohort (n=561) include are: 1(Red Line) Non-Progressors, Group 2(Green Line) Late Progressors, Group 3 (Blue Line) -Early progressors and Group 4 (Black Line) Rapid Progressors. Including adjustments included: time-variant (Tumor necrosis factor inhibitor use and abnormal C-reactive protein) and time-invariant risk-factors (e.g. gender, smoking, and disease duration).

Disclosures: M. Hwang, Novartis, 2, UCB, 2, University of Texas Health Science Center at Houston (UTHealth) Center of Clinical and Translational Sciences KL2 program, 5; M. Lee, None; L. Gensler, Novartis, 5, UCB, 5, Eli Lilly, 2, Gilead, 2, Pfizer, 2, Pfizer, 5, Janssen, 2, UCB, 2; M. Brown, None; A. Tahanan, None; M. Rahbar, None; T. Hunter, Eli Lilly and Company, 3, 11; M. Shan, Eli Lilly and Company, 3, 11; M. Ishimori, None; J. Reveille, UCB, 1, Eli Lilly, 1, Eli Lilly, 5, Novartis, 1; M. Weisman, Novartis, 2, Gilead, 2, GSK, 2, UCB, 2; T. Learch, None.

To cite this abstract in AMA style:

Hwang M, Lee M, Gensler L, Brown M, Tahanan A, Rahbar M, Hunter T, Shan M, Ishimori M, Reveille J, Weisman M, Learch T. Identifying Trajectories of Radiographic Spinal Disease in Ankylosing Spondylitis [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/identifying-trajectories-of-radiographic-spinal-disease-in-ankylosing-spondylitis/. Accessed .

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