gms | German Medical Science

44. Kongress der Deutschen Gesellschaft für Rheumatologie, 30. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie, 26. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie

31.08. - 03.09.2016, Frankfurt am Main

Clinical disease activity measures are associated with radiographic spinal progression in early axial spondyloarthritis

Meeting Abstract

  • Denis Poddubnyy - Charité - Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Gastroenterologie, Infektologie, Rheumatologie, Berlin
  • Mikhail Protopopov - Kazan State Medical University, Kazan, Russia
  • Hildrun Haibel - Charité - Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Gastroenterologie, Infektologie, Rheumatologie, Berlin
  • Jürgen Braun - Rheumazentrum Ruhrgebiet, Herne
  • Martin Rudwaleit - Klinikum Bielefeld Rosenhöhe, Bielefeld
  • Joachim Sieper - Charité - Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Gastroenterologie, Infektologie, Rheumatologie, Berlin

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. 44. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh); 30. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh); 26. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). Frankfurt am Main, 31.08.-03.09.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocSP.10

doi: 10.3205/16dgrh220, urn:nbn:de:0183-16dgrh2200

Published: August 29, 2016

© 2016 Poddubnyy et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Background: It has been shown in the past that elevated C-reactive protein (CRP) [1] and the composite Ankylosing Spondylitis Disease Activity Score (ASDAS) [2], [3] are associated with radiographic spinal progression in axial spondyloarthritis (axSpA). It is not clear, however, whether patient-reported measures of disease activity might also play a predictive role.

The aim of the current study was to investigate the association between patient-reported measures of disease activity and radiographic spinal progression over two years in early axSpA.

Methods: Altogether 178 patients with definite axSpA (100 with ankylosing spondylitis and 78 with non-radiographic axSpA) from the German Spondyloarthritis Inception Cohort (GESPIC) were included in the current study. Spinal radiographs (cervical spine lateral views, lumbar spine lateral and anteroposterior views) were scored according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) system and for the presence of syndesmophytes. Clinical and lab data were collected at baseline and every 6 months thereafter. Time-averaged values (over 2 years) of the patient global assessment of disease activity (PG), BASDAI and its components, CRP and CRP-based ASDAS, were calculated.

Results: In the logistic regression analysis there was a significant association between time-averaged patient global and syndesmophyte formation (table): the adjusted odds ratio (OR) was 1.30 (1.01-1.69) meaning a 30% increase of the chance for new syndesmophytes formation over two years with an increase of PG by 1 point (on a 0-10 scale). The time-averaged BASDAI demonstrated no significant association with radiographic spinal progression, but duration and severity of morning stiffness were both significantly associated with syndesmophytes formation with a similar strength of association as the patient global (Table 1 [Tab. 1]). Similar trends although not always significant were observed for the mSASSS worsening by 2 points and more after two years. CRP and ASDAS did show an already known association with radiographic spinal progression in early axial SpA.

Conclusion: Higher patient global assessment of disease activity, duration and severity of morning stiffness are clinical parameters, which are associated with more radiographic spinal progression (syndesmophytes formation) in patients with early axial spondyloarthritis.


References

1.
Poddubnyy D, Haibel H, Listing J, Märker-Hermann E, Zeidler H, Braun J, Sieper J, Rudwaleit M. Baseline radiographic damage, elevated acute-phase reactant levels, and cigarette smoking status predict spinal radiographic progression in early axial spondylarthritis. Arthritis Rheum. 2012 May;64(5):1388-98. DOI: 10.1002/art.33465 External link
2.
Ramiro S, van der Heijde D, van Tubergen A, Stolwijk C, Dougados M, van den Bosch F, Landewé R. Higher disease activity leads to more structural damage in the spine in ankylosing spondylitis: 12-year longitudinal data from the OASIS cohort. Ann Rheum Dis. 2014 Aug;73(8):1455-61. DOI: 10.1136/annrheumdis-2014-205178 External link
3.
Poddubnyy D, et al. Ann Rheum Dis. 2014;73(Suppl2):422.