Article Text

PDF
THU0356 Sensitivity to Change of Different Definitions of Sacroiliac Radiological Structural Changes in Early Spondyloarthritis: Data from the Desir Cohort
  1. M. Dougados1,
  2. C. Demattei2,
  3. A. Molto3,
  4. R. van den Berg4,
  5. V.V. Hoang5,
  6. F. Thevenin6,
  7. M. Reijnierse4,
  8. D. Loeuille7,
  9. A. Feydy6,
  10. P. Claudepierre8,
  11. D. van der Heijde9
  1. 1Rheumatology, René Descartes University, Paris
  2. 2Biostatistics, Montpellier
  3. 3René Descartes University, Paris, France
  4. 4LUMC, Leiden, Netherlands
  5. 5Radiology, Lyon
  6. 6Radiology - Cochin, paris
  7. 7Rhumatology, Nancy
  8. 8Rhumatology, Créteil
  9. 9LUMC, Leiden, France

Abstract

Background The natural history (with regard to the structural damage of the Sacroiliac Joints) (SIJ) of axial radiographic (r) and non-radiographic (nr) axial spondyloarthritis (SpA) is not well known.

Objectives To evaluate the 2 years SIJ radiological structural changes in early axial r- versus nr-axial SpA according to different definitions.

Methods Patients: inflammatory back pain of less than 3 years duration suggestive of axial SpA according to the treating rheumatologist (DESIR cohort). Outcome measures: Pelvic X-rays collected both at baseline and at the 2 year follow up visit were stored after anonymizing and blinding of the time collection. The radiographs were read centrally by two different readers of well calibrated central readers blinded for clinical, laboratory and other imaging data. In case of disagreement regarding the presence/absence of either sacroiliitis according to the modified New York (mNY) cri teria or change of at least one grade in one SIJ, images were adjudicated by an experienced radiologist or rheumatologist. A score from 0 (normal) to 4 (fusion) was given to each SIJ (left and right). Analysis: Several outcome measures were used: a) changes (from nr to r or from r to nr) in the SIJ status according to the mNY criteria (e.g. r in case of at least a unilateral garde 3 or bilateral grade 2), b) changes in the 0-8 total SIJ (left + right) score c) progression/improvement defined by a change of at least one grade (≥+1/≤-1) in either the left or right SIJ, d) Progression defined by a change of at least one grade in either the left or right SIJ AND a 2 year value of at least 2 in this joint with a progression of at least one grade.

Results The table summarizes the changes observed in the 449 evaluated patients (age: 34±9 + years old, male: 47%, HLA B27 positive: 61%) according to the baseline radiographic status

Table 1.

Two years radiological SIJ changes in 449 SpA patients with early disease

Conclusions These data suggest that in early SpA a) the structural progression does exist but is quite small and only observed in a small number of patients, b) there is a relatively high rate of improvement indicating that it is difficult to assess the true progression rate c) the total SIJ score and/or the progression defined by a change of at least one grade are the most sensitive, d) such rate of progression is higher in the sub-group of patients fulfilling the mNY criteria at baseline.

Acknowledgements DESIR is financially supported by an unrestricted grant from PFIZER France and the French Society of Rheumatology

Disclosure of Interest None declared

Statistics from Altmetric.com

Request permissions

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.