Background Ankylosing spondylitis (AS) is associated with an increased incidence of vertebral fractures (VFs). Previous studies report the prevalence of morphometric VFs; however, the actual incidence and predictors of morphometric VFs in AS remains unclear.
Objectives The present study examined the incidence and predictors of new VFs in a large AS cohort.
Methods Two hundred and ninety-eight AS patients who fulfilled the modified New York criteria were enrolled and spinal radiographs were evaluated biennially. Clinical and laboratory data and radiographic progression were assessed according to the BASDAI, ESR, CRP, and the Stoke AS spine score (SASSS). VF was defined according to the Genant criteria. The incidence of VFs at 2 years and 4 years was evaluated using the Kaplan-Meier method. The age-specific standardized prevalence ratio (SPR) for AS patients in comparison with the general population was calculated.
Results Of 298 patients, 31 (10.8%) had previous VFs at baseline. Thirty new VFs occurred in 26 patients over 4 years. The incidence of morphometric VFs was 4.7% at 2 years and 13.6% at 4 years. Multivariate logistic regression analysis showed that previous VFs at baseline and increased CRP levels at 2 years were predictors of new VFs (OR =12.8, 95% CI =3.6–45.3 and OR=5.4, 95% CI =1.4–15.9). The age-specific SPR of morphometric VFs in AS was 3.3 (95% CI 2.1–4.5).
Conclusions The incidence of morphometric VFs increased in AS. Previous VFs and increased CRP levels predicted future VFs. An appropriate anti-inflammatory therapy may prevent the incidence of new VFs in AS patients with and without previous VFs.
Disclosure of Interest : None declared
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.