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Clinical and epidemiological research
Extended report
Sacroiliac radiographic progression in recent onset axial spondyloarthritis: the 5-year data of the DESIR cohort
  1. Maxime Dougados1,2,
  2. Alexandre Sepriano3,4,
  3. Anna Molto2,5,
  4. Miranda van Lunteren3,
  5. Sofia Ramiro3,
  6. Manouk de Hooge3,
  7. Rosaline van den Berg3,
  8. Victoria Navarro Compan6,
  9. Christophe Demattei7,
  10. Robert Landewé8,
  11. Désirée van der Heijde3
  1. 1Department of Rheumatology, Paris Descartes University, Hôpital Cochin, Hôpitaux de Paris, Paris, France
  2. 2INSERM (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-City, Paris, France
  3. 3Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  4. 4NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
  5. 5Department of Rheumatology, Hôpital Cochin, Paris, France
  6. 6Department of Rheumatology, University Hospital La Paz, IdiPaz, Madrid, Spain
  7. 7Department of Biostatistics, Epidemiology, Public Health and Medical Information (BESPIM), Nimes University Hospital, Nimes, France
  8. 8Amsterdam Rheumatology & Clinical Immunology Center (ARC), Amsterdam and Zuyderland Medical Center, Heerlen, The Netherlands
  1. Correspondence to Professor Maxime Dougados, INSERM (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-City, Paris 14, France; maxime.dougados{at}aphp.fr

Abstract

Objective To estimate sacroiliac joint radiographic (X-SIJ) progression in patients with axial spondyloarthritis (axSpA) and to evaluate the effects of inflammation on MRI (MRI-SIJ) on X-SIJ progression.

Methods X-SIJ and MRI-SIJ at baseline and after 2 and 5 years in patients with recent onset axSpA from the DESIR cohort were scored by three central readers. Progression was defined as (1) the shift from non-radiographic (nr) to radiographic (r) sacroiliitis (by modified New York (mNY) criteria) or alternative criteria, (2) a change of at least one grade or (3) a change of at least one grade but ignoring a change from grade 0 to 1. The effects of baseline inflammation on MRI-SIJ on 5-year X-SIJ damage (mNY) were tested by generalised estimating equations.

Results In 416 patients with pairs of baseline and 5-year X-SIJ present, net progression occurred in 5.1% (1), 13.0% (2) and 10.3% (3) respectively, regarding a shift from nr-axSpA to r-axSpA (1), a change of at least one grade (2) or a change of at least one grade but ignoring a change from grade 0 to 1 (3). Baseline MRI-SIJ predicted structural damage after 5 years in human leukocyte antigen-B27 (HLA-B27) positive (OR 5.39 (95% CI 3.25 to 8.94)) and in HLA-B27 negative (OR 2.16 (95% CI 1.04 to 4.51)) patients.

Conclusions Five-year progression of X-SIJ damage in patients with recent onset axSpA is limited but present beyond measurement error. Baseline MRI-SIJ inflammation drives 5-year radiographic changes.

  • spondyloarthritis
  • magnetic resonance imaging
  • epidemiology
  • outcomes research

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/annrheumdis-2017-211596

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    Footnotes

    • Contributors All authors contributed and finally approved the current manuscript.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Comitte de Protection des Personnes Ile de France III.

    • Provenance and peer review Not commissioned; externally peer reviewed.