Rate and predisposing factors of sacroiliac radiographic progression after a 2 years follow-up period in recent onset spondyloarthritis

août 30, 2016 | Posted by admin

Un nouvel article scientifique intitulé « Rate and predisposing factors of sacroiliac radiographic progression after a 2 years follow-up period in recent onset spondyloarthritis.» a été publié dans le journal Arthritis Rheumatol.

Dougados M, Demattei C, van den Berg R, Hoang VV, Thevenin F, Reijnierse M, Loeuille D, Feydy A, Claudepierre P, van der Heijde D.

Arthritis Rheumatol. 2016 Mar 18. doi: 10.1002/art.39666.

Abstract

OBJECTIVES:

to evaluate in radiographic (r) and non-radiographic (nr) axial (ax) spondyloarthritis (SpA) 1) the rate of radiographic sacroiliac joints (SIJ) structural progression 2) to evaluate the predisposing factors of such progression over 2 years.

METHODS:

Patients:Recent onset axial SpA(DESIR cohort).

OUTCOME MEASURES:

Radiographic SIJ score according to the mNew-York criteria (mNY). Potential predisposing factors: Demographics, smoking status, HLAB27 positivity, inflammation at MRI of the SIJ, disease activity and treatment intake .

ANALYSIS:

The main analysis consisted in the evaluation of the switch from nr-to r-axSpA but also other definitions of radiographic progression.

RESULTS:

of the 708 enrolled patients, 449 had baseline and 2-year pelvic radiographs(males: 47%, age: 34±9 years old, B27 positive: 61%, MRI-SIJ positive: 29%) . The % of switch from nr-to-r-axSpA (16/326: 4.9%) and from r-to-nr-axSpA: 7/123 (5.7%) was low. The mean changes in the total SIJ score (o-8) was small 0.1± 0.8 but highly statistically significant (p<0.001). The potential baseline predisposing factors for developing mNY criteria in the multivariate analysis were current smokers, HLAB27 positivity and MRI-SIJ positivity with the following respective odds-ratio: 3.3 [1.0 - 11.5], 12.6 [2.3 - 274] and 498 [9.3 - 904].

CONCLUSION:

Our study suggest that in early SpA: a)The structural progression does exist but is quite small and observed in a small number of patients b) Both environmental (smoking status), genetic (HLAB27 positivity) and inflammatory (MRI-SIJ) markers might be independent predisposing factors of progression. This article is protected by copyright. All rights reserved.

KEYWORDS: Imaging; Spondyloarthritis; X-Rays

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