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45. Kongress der Deutschen Gesellschaft für Rheumatologie, 31. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie, 27. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie

06.09. - 09.09.2017, Stuttgart

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Functional parameters and spinal mobility are associated with radiographic sacroiliitis severity in patients with axial spondyloarthritis: results from the GErman SPondyloarthritis Inception Cohort

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  • Mikhail Protopopov - Charité - Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Gastroenterologie, Infektologie, Rheumatologie, Berlin
  • Joachim Sieper - Charité - Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Gastroenterologie, Infektologie, Rheumatologie, Berlin
  • Hildrun Haibel - Charité - Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Gastroenterologie, Infektologie, Rheumatologie, Berlin
  • Joachim Listing - Deutsches Rheuma-Forschungszentrum (DRFZ), Programmbereich Epidemiologie, Berlin
  • Martin Rudwaleit - Klinikum Bielefeld Rosenhöhe, Bielefeld
  • Denis Poddubnyy - 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. 45. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 31. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), 27. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). Stuttgart, 06.-09.09.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocSpA.03

doi: 10.3205/17dgrh204, urn:nbn:de:0183-17dgrh2042

Published: September 4, 2017

© 2017 Protopopov 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

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Background: The association of spinal mobility with spinal structural damage, disease activity parameters and spinal inflammation is well established. The goal of the study was to determine whether the higher grades of radiographic sacroiliitis may also impact function and spinal mobility in patients with axial spondyloarthritis (axSpA).

Methods: The study included 210 patients with axSpA (115 with radiographic and 95 with non-radiographic axSpA) from the German Spondyloarthritis Inception Cohort (GESPIC). Standard pelvic radiographs were performed at baseline and after 2 years of the follow up. Two trained readers scored the images according to the modified New York criteria grade 0 to 4 for each joint). A mean of two readers score for each joint and a sum score for both SIJ were calculated for each patient, giving a total sacroiliitis score between 0 and 8. Bath Ankylosing Spondylitis Functional Index (BASFI) and the Bath Ankylosing Spondylitis Metrology Index (BASMI) were used to assess the functional status and spinal mobility, respectively.

Results: In the longitudinal mixed model analysis adjusted for the presence of structural damage in the spine (modified Stoke Ankylosing Spondylitis Spine Score - mSASSS), disease activity (Bath Ankylosing Spondylitis Disease Activity Index – BASDAI and level of C-reactive protein – CRP) and sex, radiographic sacroiliitis was independently associated with the BASFI: β=0.10 (95%CI 0.01-0.19) and the BASMI: β=0.12 (95%CI 0.03-0.21), respectively. These data indicate that change by one radiographic sacroiliitis grade in one sacroiliac joint is associated with a BASFI / BASMI worsening by 0.10 / 0.12 points independently of structural damage in the spine and disease activity. Similar results for both outcomes were obtained by sensitivity analysis performed in radiographic and non-radiographic axSpA subgroups separately.

Conclusion: Radiographic sacroiliitis might have an impact, although small, on physical function and spinal mobility in patients with axial SpA, independently of other factors.