ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 2840

Predictors Of Spinal Mobility Progression In A Multi-ethnic Cohort Of Patients With Ankylosing Spondylitis

Roozbeh Sharif1, Trisha M. Parekh2, Lianne S. Gensler3, MinJae Lee4, Mohammad Rahbar5, Laura A. Diekman6, Michael H. Weisman7, Michael M. Ward8, Shervin Assassi9 and John D. Reveille9, 1Graduate School of Biomedical Science, University of Texas Medical Branch, Galveston, TX, 2Internal Medicine, University of Texas Medical Branch, Galveston, TX, 3Medicine/Rheumatology, University of California, San Francisco, San Francisco, CA, 4Biostatistics/Epidemiology/Research Design (BERD) Core | Center for Clinical and Translational Sciences, University of Texas Health Science Center at Houston, Houston, TX, 5The University of Texas Health Science Center at Houston, Houston, TX, 6Rheumatology, The University of Texas Health Science Center at Houston, Houston, TX, 7Rheumatology, Cedars-Sinai Medical Center, Los Angeles, CA, 8Bldg 10 CRC Rm 4-1339, NIAMS/NIH, Bethesda, MD, 9Rheumatology, University of Texas Health Science Center at Houston, Houston, TX

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Ankylosing spondylitis (AS), anti-TNF therapy and functional status, Disease Activity

  • Tweet
  • Email
  • Print
Session Information

Session Title: Spondylarthropathies and Psoriatic Arthritis: Clinical Aspects and Treatment: Clinical and Imaging Aspects of Axial Spondyloarthritis

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Clinicians utilize several different clinical measurements (metrology) in patients with Ankylosing Spondylitis (AS) to assess the spinal mobility.  We aimed to examine the pattern of change in metrology over time and to evaluate the factors associated with these changes.

Methods:

In a prospective study, we included participants from a multi-ethnic, multi-center cohort of AS patients meeting modified New York criteria.  The primary outcomes were eight individual clinical measurements, recorded at baseline and follow up visits every 6 months: cervical rotation and flexion, occiput to wall distance, chest expansion, modified Schober, lateral lumbar spinal flexion, and hip internal/external rotation.  The independent variables included demographic, health habits, medications, radiologic and the patient-perceived functional limitation index (Bath AS Functional and Disease Activity Indices [BASFI & BASDAI]).  Mixed models that accounted for correlation of repeated measures longitudinally as well as interaction with time were conducted to examine whether the spinal mobility pattern is changed by each of independent variables among AS patients.

Results:

Overall, 611 patients, including 177 female (29%) and 462 (75.7%) non-Hispanic white were followed up to 4 years.   The univariable analyses are shown in table 1.  Age, sex, disease duration, smoking habits, radiologic severity and patient perceived functional limitation and disease activity indices at baseline were associated with metrology over time.  However, ethnicity and treatment with NSAID and anti-tumor necrosis factor (TNF)-α medications at baseline did not correlate with metrology over time among AS patients. Multivariable analysis indicated that after adjusting for age, sex, employment status, BASFI and BASRI at baseline, age>40 at enrollment associated with worse outcome among all measurements, except hip rotation. Gender, race, and educational status were not associated with the longitudinal changes in metrology. Smoking at baseline visit was associated with greater worsening of lateral flexion and cervical flexion and rotation. Moreover, being employed as well as lower BASDAI, BASFI, and BASRI score at baseline were associated with slower progression over time, across all eight metrology indices.

Conclusion:

Demographics and disease severity indices at baseline were independent correlates of the worsening of clinical measurements among patients with AS. Further studies are encouraged to identify whether reversing the potentially modifiable factors such as smoking cessation can slow the rate of progression.

Table 1.  Univariable longitudinal analysis of demographic and clinical factors associated with deterioration of mobility over time among patients with ankylosing spondylitis

Predictor factor

Cervical flexion

Cervical rotation

Chest expansion

Hip external rotation

Hip internal rotation

Lateral lumbar spine flexion

Occiput to wall

Schober test

Age ≥40 years

-24.4
(<0.001) *

-29.6
(<0.001)

-1.2
(<0.001)

-1.6
(0.003)

-2.8
(<0.001)

-4.9
(<0.001)

-3.7
(<0.001)

-0.9
(<0.001)

Sex, male

-9.1
(0.001)

-7.3
(0.040)

-0.3
(0.065)

0.6
(0.557)

-2.8
(<0.001)

-1.5
(0.006)

3.2
(<0.001)

-0.3
(0.026)

Ethnicity, non-Hispanic white

1.8
(0.761)

-0.3
(0.908)

0.6
(0.011)

0.1
(0.319)

-0.3
(0.291)

0.6
(0.604)

-0.1
(0.662)

0.2
(0.393)

Educational level, college degree or above

-1.1
(0.814)

-0.5
(0.530)

0.3
(0.057)

1.3
(0.254)

1.8
(0.104)

0.9
(0.244)

-2.3
(0.027)

0.3
(0.029)

Employment status, disabled

-23.2
(<0.001)

-33.5
(<0.001)

-1.4
(<0.001)

-2.6
(0.001)

-3.8
(<0.001)

-4.9
(<0.001)

5.6
(<0.001)

-1.3
(<0.001)

Smoking , current smoker

-11.2
(<0.001)

-13.8
(<0.001)

-0.6
(<0.001)

-0.5
(0.126)

-1.4
(0.006)

-2.3
(<0.001)

3.0
(<0.001)

-0.4
(<0.001)

Disease duration, >17 years

-24.9
(<0.001)

-33.4
(<0.001)

-1.1
(<0.001)

-0.2
(0.797)

-2.2
(0.004)

-4.9
(<0.001)

4.2
(<0.001)

-1.1
(<0.001)

History of joint surgery

-20.6
(<0.001)

-34.4
(<0.001)

-0.8
(<0.001)

-5.0
(<0.001)

-4.9
(<0.001)

-3.8
(<0.001)

2.5
(<0.001)

-0.8
(<0.001)

BASFI** ≥26

-20.1
(<0.001)

-27.4
(<0.001)

-1.4
(<0.001)

-3.3
(<0.001)

-4.5
(<0.001)

-4.8
(<0.001)

3.9
(<0.001)

-1.2
(<0.001)

BASDAIβ ≥4

-4.9
(0.034)

-9.6
(0.001)

-0.5
(0.005)

-2.6
(<0.001)

-1.7
(0.011)

-1.2
(0.018)

1.4
(0.206)

-0.4
(0.002)

BASRIγ ≥6

-35.7
(<0.001)

-43.8
(<0.001)

-2.0
(<0.001)

-1.3
(0.022)

-4.4
(<0.001)

-7.4
(<0.001)

6.5
(<0.001)

-1.7
(<0.001)

mSASSSα≥5

-35.5
(<0.001)

-43.7
(<0.001)

-1.9
(<0.001)

-1.2
(0.078)

-3.9
(<0.001)

-7.4
(<0.001)

6.2
(<0.001)

-1.7
(<0.001)

NSAID¥

6.3
(0.786)

6.9
(0.241)

0.1
(0.121)

1.2
(0.344)

-0.2
(0.434)

1.2
(0.972)

-0.6
(0.665)

0.3
(0.343)

Anti TNF-α  agent use

-2.6
(0.838)

-4.1
(0.616)

-0.1
(0.012)

-1.4
(0.048)

-0.5
(0.364)

-0.2
(0.538)

0.2
(0.210)

0.1
(0.161)

* mean difference (p-value) ; **BASFI: Bath AS Functional Index ; βBASDAI: Bath AS Disease Activity Index γBASRI: Bath Ankylosing Spondylitis Radiology Index αmSASSS: modified Stoke Ankylosing Spondylitis Spine Score and ¥NSAID: Nonsteroidal anti-inflammatory drugs


Disclosure:

R. Sharif,
None;

T. M. Parekh,
None;

L. S. Gensler,
None;

M. Lee,
None;

M. Rahbar,
None;

L. A. Diekman,
None;

M. H. Weisman,
None;

M. M. Ward,
None;

S. Assassi,
None;

J. D. Reveille,
None.

  • Tweet
  • Email
  • Print

« Back to 2013 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/predictors-of-spinal-mobility-progression-in-a-multi-ethnic-cohort-of-patients-with-ankylosing-spondylitis/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2022 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies