Disease activity is longitudinally related to sacroiliac inflammation on MRI in male patients with axial spondyloarthritis: 2-years of the DESIR cohort

Objectives To investigate the longitudinal relationship between inflammatory lesions in sacroiliac joints on MRI (MRI-SI) and clinical disease activity measures (DA) in patients with axial spondyloarthritis (axSpA). Methods Two-year follow-up data from 167 patients (50% males, mean (SD) age 33 (9) years) fulfilling the Assessment of SpondyloArthritis international Society axSpA criteria in the DEvenir des Spondylarthopathies Indifférenciées Récentes cohort with MRI-SI at baseline, 1 year and 2 years were analysed. The relationship between MRI-SI (as dependent variable) and DA (Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), patient's global DA, night pain, C reactive protein and erythrocyte sedimentation rate, as independent variables) was investigated using two types of generalised estimating equations (GEE) models: model of absolute scores and model of change scores. Results In the model of absolute scores, the relationship between DA and MRI-SI was different for males and females: in males, but not in females, a statistically significant relationship with MRI-SI was found for all DA except BASDAI. In the model of changes, only ASDAS (beta (95% CI): 2.79 (0.85 to 4.73) and pain at night (0.97 (0.04 to 1.90)) were significantly associated in males while again in females no significant relationship was found. ASDAS fitted the data best. Conclusions In male patients, but not in female patients, with axSpA, clinical DA, especially if measured by ASDAS, is longitudinally associated with MRI-SI inflammatory lesions.

[1]  R. Landewé,et al.  Brief Report: Calculating the Ankylosing Spondylitis Disease Activity Score If the Conventional C‐Reactive Protein Level Is Below the Limit of Detection or If High‐Sensitivity C‐Reactive Protein Is Used: An Analysis in the DESIR Cohort , 2015, Arthritis & rheumatology.

[2]  M. Dougados,et al.  Higher disease activity leads to more structural damage in the spine in ankylosing spondylitis: 12-year longitudinal data from the OASIS cohort , 2014, Annals of the rheumatic diseases.

[3]  M. Brown,et al.  Spinal Inflammation in the Absence of Sacroiliac Joint Inflammation on Magnetic Resonance Imaging in Patients With Active Nonradiographic Axial Spondyloarthritis , 2014, Arthritis & rheumatology.

[4]  J. Listing,et al.  Good correlation between changes in objective and subjective signs of inflammation in patients with short- but not long duration of axial spondyloarthritis treated with tumor necrosis factor-blockers , 2014, Arthritis Research & Therapy.

[5]  M. Dougados,et al.  Which spinal lesions are associated with new bone formation in patients with ankylosing spondylitis treated with anti-TNF agents? A long-term observational study using MRI and conventional radiography , 2013, Annals of the rheumatic diseases.

[6]  R. Landewé,et al.  How to calculate the ASDAS if the conventional CRP is below the limit of detection or if using high sensitivity CRP? – An analysis in the DESIR cohort , 2014 .

[7]  Jos W. R. Twisk,et al.  Applied Longitudinal Data Analysis for Epidemiology: References , 2013 .

[8]  M. Ostergaard,et al.  The diagnostic utility of MRI in spondyloarthritis. , 2012, Best practice & research. Clinical rheumatology.

[9]  R. Landewé,et al.  MRI inflammation and its relation with measures of clinical disease activity and different treatment responses in patients with ankylosing spondylitis treated with a tumour necrosis factor inhibitor , 2012, Annals of the rheumatic diseases.

[10]  J. Braun,et al.  The degree of spinal inflammation is similar in patients with axial spondyloarthritis who report high or low levels of disease activity: a cohort study , 2012, Annals of the rheumatic diseases.

[11]  D. M. van der Heijde,et al.  Health and imaging outcomes in axial spondyloarthritis , 2016 .

[12]  H. Bodur,et al.  Spinal inflammation by magnetic resonance imaging in patients with ankylosing spondylitis: association with disease activity and outcome parameters , 2012, Rheumatology International.

[13]  M. Dougados,et al.  The DESIR cohort: a 10-year follow-up of early inflammatory back pain in France: study design and baseline characteristics of the 708 recruited patients. , 2011, Joint, bone, spine : revue du rhumatisme.

[14]  D. M. van der Heijde,et al.  HLA-B27 and gender independently determine the likelihood of a positive MRI of the sacroiliac joints in patients with early inflammatory back pain: a 2-year MRI follow-up study , 2011, Annals of the Rheumatic Diseases.

[15]  W. Maksymowych,et al.  Focal fat lesions at vertebral corners on magnetic resonance imaging predict the development of new syndesmophytes in ankylosing spondylitis. , 2011, Arthritis and rheumatism.

[16]  A. Loft,et al.  Responsiveness of the Ankylosing Spondylitis Disease Activity Score (ASDAS) and clinical and MRI measures of disease activity in a 1-year follow-up study of patients with axial spondyloarthritis treated with tumour necrosis factor α inhibitors , 2009, Annals of the rheumatic diseases.

[17]  D. Gladman,et al.  Reappraisal of OMERACT 8 Draft Validation Criteria for a Soluble Biomarker Reflecting Structural Damage Endpoints in Rheumatoid Arthritis, Psoriatic Arthritis, and Spondyloarthritis: The OMERACT 9 v2 Criteria , 2009, The Journal of Rheumatology.

[18]  D. M. van der Heijde,et al.  Defining active sacroiliitis on magnetic resonance imaging (MRI) for classification of axial spondyloarthritis: a consensual approach by the ASAS/OMERACT MRI group , 2009, Annals of the rheumatic diseases.

[19]  M. Østergaard,et al.  Inflammatory lesions of the spine on magnetic resonance imaging predict the development of new syndesmophytes in ankylosing spondylitis: evidence of a relationship between inflammation and new bone formation. , 2009, Arthritis and rheumatism.

[20]  David Salonen,et al.  Spondyloarthritis Research Consortium of Canada Magnetic Resonance Imaging Index For Assessment of Sacroiliac Joint Inflammation in Ankylosing Spondylitis , 2005 .

[21]  David Salonen,et al.  Spondyloarthritis Research Consortium of Canada magnetic resonance imaging index for assessment of spinal inflammation in ankylosing spondylitis. , 2005, Arthritis and rheumatism.

[22]  L. Braitman,et al.  Applied Longitudinal Data Analysis for Epidemiology: A Practical Guide , 2004, Annals of Internal Medicine.

[23]  T. McCauley,et al.  Sacroiliitis in patients with ankylosing spondylitis: association of MR findings with disease activity. , 2004, Magnetic resonance imaging.