Artikel
Structural damage in axial Spondyloarthritis: is there a preferred way to assess progression over time?
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Autoren
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Xenofon Baraliakos
- Rheumazentrum Ruhrgebiet, Herne; Ruhr-Universität Bochum, bochum
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Valeria Rios Rodriguez
- Charité-Universitätsmedizin Berlin, Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Berlin
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Murat Torgutalp
- Charité-Universitätsmedizin Berlin, Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Berlin
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Anil Dilbaryan
- Charité-Universitätsmedizin Berlin, Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Berlin
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Hildrun Haibel
- Charité-Universitätsmedizin Berlin, Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Berlin
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Maryna Verba
- Charité-Universitätsmedizin Berlin, Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Berlin
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Joachim Sieper
- Charité-Universitätsmedizin Berlin, Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Berlin
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Jürgen Braun
- Rheumazentrum Ruhrgebiet, Herne; Ruhr-Universität Bochum, bochum
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Martin Rudwaleit
- Klinikum Bielefeld Rosenhöhe, Universitätsklinikum OWL, Bielefeld
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Denis Poddubnyy
- Charité-Universitätsmedizin Berlin, Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Berlin; Deutsches Rheuma-Forschungszentrum, Berlin
| Veröffentlicht: | 14. September 2021 |
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Gliederung
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Objective: Investigate the performance of the modified Stokes Ankylosing Spondylitis Scoring System (mSASSS) in assessing spinal radiographic damage and progression in axial spondyloarthritis (axSpA) using different approaches of radiographs (CR) evaluations.
Methods: Cervical and lumbar CRs of axSpA patients from GESPIC at baseline and after 2 years were scored by 5 readers (2 blinded, 3 unblinded) using the mSASSS. The final mSASSS score was calculated as the mean score of readers.
Results: 115 radiographic and 95 non-radiographic patients were included. The mean mSASSS at baseline was 4.3±8.3 vs. 3.4±7.9, while the mean radiographic progression was 0.7±2.3 vs.1.0±1.9 mSASSS units for the blinded vs. the unblinded group (Figure 1 [Fig. 1]). On the patient level, progression of ≥2 mSASSS units was found in 30 (14.3%) vs. 37 (17.6%) patients in the blinded vs. the unblinded group, while agreement between groups was seen in 179 (85.2%) patients, 18 (8.9%) for progression and 161 (76.7%) for no progression.
In a more specific analysis of ‘definite’ CR findings, the mean mSASSS score at baseline was 3.3±8.0 vs. 2.6±7.2 and the mean radiographic progression was 0.6±2.4 vs. 0.8±2.1 mSASSS units for the blinded vs. the unblinded group. On the patient level, progression was found in 37 (17.6%) vs. 33 (15.7%) patients in the blinded vs. the unblinded group, while agreement between groups was seen in 188 (89.5%), 24 (11.3%) for progression and in 164 (78.1%) for no progression.
In the shift analysis, mSASSS worsening was found in 35 (0.8%) and ‘improvement’ in 4 (0.1%) out of 4.373 vertebral edges analyzed in the blinded group and in 109 (2.2%) and 2 (0.04%), respectively, out of 4.914 analyzed in the unblinded group (Table 1 [Tab. 1]). The majority of progression was found for the development of ‘definite’ signs of progression in both the blinded (25/35, 71.4%) and the unblinded (61/109, 56%) group, while more ‘minor’ signs of progression were found in the unblinded (48/109, 44%) compared to the blinded (10/25, 28.6%) group.
Conclusion: Despite lower mean mSASSS baseline values, higher mean mSASSS progression was found with the unblinded approach, while in the shift analysis this approach was more specific, confirming the absence of ‘improvement’ over time.
Disclosures: None declared
