Early inflammation predicts progression in SpA

Baseline sacroiliac joint inflammation seen on MRI predicts subsequent structural progression in people with recent onset axial SpA, five-year data from the DESIR cohort shows.

Presenting the data to the congress Professor Maxime Dougados from the Cochin Hospital in Paris said the findings suggested an MRI of the sacroiliac joints should be performed in all patients presenting with axial spondyloarthritis.

Of 416 patients involved in the 10-year longitudinal study 62 (14.9%) were considered to have radiographic axial SpA at baseline based on mNY criteria, with 24 (5.8%) of these patients changed from mNY negative to mNY positive after 5-years.

Factors that predisposed patients to radiographic progression at 5 years included bone marrow odema (OR=4.85 [95% CI: 2.95-7.97]) together with a younger age (OR=0.97 [95% CI: 0.94-0.99]) and longer symptom duration (OR=1.40 [95% CI: 1.04-1.89]).

Another study involving the same cohort found a lower than expected rate of progression in the patient population.

“We expected 50-70% of radiographic axial spondyloarthritis after 5 years follow-up but we observed 20%,” Professor Dougados said.

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