Spinal radiographic progression in early axial Spondyloarthritis: Five-year results from the DESIR cohort.

OBJECTIVES: To analyse the progression of spinal radiographic damage in patients with early axial spondyloarthritis (axSpA).

METHODS: AxSpA patients from the DESIR cohort with 5-year spinal (cervical and lumbar) radiographs available (n=549). Two- and 5-year mSASSS progression and development of new syndesmophytes (net change: number of patients with positive change minus number of patients with negative change divided by total number of patients) were assessed in subgroups defined at baseline according to the ASAS axSpA criteria and its arms, mNYC and the presence of syndesmophytes.

RESULTS: Mean mSASSS progression was 0.2(SD 0.9) at 2 years and 0.4(1.8) at 5 years. Five-year progression was higher in the imaging arm (0.6(2.3), MRI+mNYC+ (1.3(4.0)) than in the clinical arm only (0.1(0.7)), and highest in patients with syndesmophytes (2.7(5.0)). At 5 years, 7% of all patients had a net change of any new syndesmophyte; this was 10% for the imaging arm (mNYC+MRI+: 18%), 17% for mNYC+ and 42% for patients with syndesmophytes.

CONCLUSION: Spinal radiographic progression, though limited in early axSpA, can be captured after 2 years. Inflammation and damage in the SIJ are associated with higher radiographic progression. The presence of baseline syndesmophytes strongly predicts the development of further structural damage already early in the disease. This article is protected by copyright. All rights reserved.