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Low incidence of vertebral fractures in early spondyloarthritis: 5-year prospective data of the DESIR cohort
  1. Julie Sahuguet1,
  2. Jacques Fechtenbaum1,
  3. Anna Molto1,2,
  4. Adrien Etcheto1,
  5. Clementina López-Medina2,
  6. Pascal Richette3,
  7. Maxime Dougados1,2,4,
  8. Christian Roux1,2,4,
  9. Karine Briot1,2
  1. 1 Department of Rheumatology, Cochin Hospital, Assistance Publique- Hôpitaux de Paris, Paris, France
  2. 2 INSERM U1153, Paris, France
  3. 3 Department of Rheumatology, Lariboisière Hospital, Assistance Publique- Hôpitaux de Paris, Paris, France
  4. 4 Paris Descartes University, Paris, France
  1. Correspondence to Karine Briot, Cochin Hospital, Department of Rheumatology, 27 rue du Faubourg St Jacques, Paris 75014, France; karine.briot{at}


Objectives An increased risk of vertebral fractures (VFs) has been reported in spondyloarthritis (SpA). Our hypothesis is that the prevalence of VFs is lower than reported in previous studies, especially in early SpA. This study aimed at assessing the incidence of radiographical VFs over 5 years in early axial SpA.

Methods The DESIR (DEvenir des Spondylarthropathies Indifférenciées Récentes) cohort, which included patients with inflammatory back pain highly suggestive of axial SpA, is the basis of this study. All radiographs of the DESIR cohort had been assessed at a central facility, by one investigator specialised in the field of the diagnosis of VFs according to Genant’s method. We assessed the prevalence and incidence of VFs and vertebral deformities at baseline and over 5 years.

Results Five-year X-rays were available for 432 patients (mean age 34.3±8.7 years, 53% women). Diagnosis of VF was doubtful and needed adjudication for 19 patients (4.4%). 13 patients had prevalent VFs (3.0%) which were located at the thoracic spine (12 were grade 1). At 5 years, five patients had an incident VF (1.15%); seven vertebrae were fractured, mostly located at the thoracic spine (n=6/7), and of grade 1 (n=6/7).

Conclusion In the DESIR cohort, a population of early SpA, we found a low prevalence and incidence of VFs (3.0% and 1.15 %), respectively. This confirms our hypothesis that the actual prevalence and incidence of VFvertebral fracture in SpA is lower than that reported in the previous studies.

  • vertebral fracture
  • X-rays
  • spondyloarthritis
  • osteoporosis
  • vertebral deformation
  • inflammation

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  • Handling editor Josef S Smolen

  • Correction notice This article has been corrected since it published Online First. The sixth author's name has been corrected to Pascal Richette.

  • Contributors The author and the coauthors contributed equally to this paper: design of the work, analysis and/or interpretation of data, drafting the work or revising it critically, and final approval of the version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

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