Early Diagnosis of Axial Spondyloarthritis Is Associated With Less Long-Term Spinal Structural Damage: A Longitudinal Analysis of the Swiss Clinical Quality Management in Rheumatic Diseases Registry.

IF 9.9 1区医学 Q1 RHEUMATOLOGY

Arthritis & Rheumatology Pub Date : 2026-09-18 DOI:10.1002/art.70346

Annik Steimer, Jonas Brändli, Mauro Bachmann, Andrea Götschi, Claudia L Rodrigues, Michael J Nissen, Burkhard Möller, Kristina Bürki, Martin Wendiggensen, Simon Grosswiler, Michael Andor, Diana Dan, Frauke Förger, Sabine Adler, Diego Kyburz, Oliver Distler, Raphael Micheroli, Sofia Ramiro, Adrian Ciurea

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引用次数: 0

Abstract

Objective: The Assessment of SpondyloArthritis international Society recently defined early axial spondyloarthritis (axSpA) as a duration of two years or less of axial symptoms. Previous studies have shown no significant difference in short-term outcomes between patients with early and established axSpA treated with biologic/targeted synthetic disease-modifying antirheumatic drugs. To evaluate long-term outcomes, we compared spinal radiographic progression between patients with early and established axSpA who were observed under standard of care treatment in a large Swiss cohort.

Methods: Patients with axSpA who had at least two sets of spinal radiographs between 2004 and 2024 in the Swiss Clinical Quality Management registry were scored with the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) by two readers and an adjudicator in case of disagreement. Longitudinal radiographic progression between early and established axSpA was compared (from the time of diagnosis) using a four-parametric logistic model, accounting for the nonlinear progression of mSASSS.

Results: Among 376 patients with 1,181 sets of radiographs, 138 patients had early and 238 had established axSpA. Baseline characteristics were similar between the two groups, with a male predominance (61%) and a high prevalence of HLA-B27 positivity (69%). Mean (SD) overall follow-up was 11.5 (8.6) years. Patients with early axSpA exhibited a lower long-term mSASSS (-3.85 mSASSS units, 95% confidence interval [CI] -7.28 to -0.42) compared with established axSpA. This difference became evident 10 to 15 years after diagnosis. The results remained statistically significant after adjustment for baseline radiographic damage (-5.70 mSASSS units, 95% CI -9.31 to -2.09).

Conclusion: Early diagnosis of axSpA is associated with lower long-term spinal structural damage.

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轴性脊柱炎的早期诊断与较少的长期脊柱结构损伤相关：瑞士临床质量管理风湿病登记处的纵向分析。

目的：国际脊椎关节炎评估协会最近将早期轴性脊椎关节炎（axSpA）定义为持续时间≤2年的轴性症状。先前的研究表明，使用生物/靶向合成疾病改善抗风湿药物治疗早期和已建立的axSpA患者的短期结局无显著差异。为了评估长期结果，我们在一个大型瑞士队列中比较了早期和已确诊的axSpA患者在标准护理治疗下的脊柱放射学进展。方法：在2004年至2024年期间，在瑞士临床质量管理注册中心至少有两组脊柱x线片的axSpA患者由两名读者使用改良的Stoke强直性脊柱炎脊柱评分（mSASSS）进行评分，如果存在分歧，则由一名评判员进行评分。使用四参数logistic模型比较早期和建立的axSpA之间的纵向x线片进展（从诊断时开始），考虑到mSASSS的非线性进展。结果：376例患者1181套x线片中，早期发现138例，建立axSpA 238例。两组患者的基线特征相似，男性占多数（61%），人类白细胞抗原(HLA)-B27阳性高流行率（69%）。平均（SD）总随访时间为11.5（8.6）年。与已建立的axSpA相比，早期axSpA患者的长期mSASSS较低（-3.85 mSASSS单位，95%CI -7.28至-0.42）。这种差异在诊断后10-15年变得明显。调整基线放射学损伤后，结果仍然具有统计学意义（-5.70 mSASSS单位，95%CI -9.31至-2.09）。结论：早期诊断与较低的长期脊柱结构损伤相关。

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来源期刊

Arthritis & Rheumatology RHEUMATOLOGY-

CiteScore

20.90

自引率

3.00%

发文量

371

期刊介绍： Arthritis & Rheumatology is the official journal of the American College of Rheumatology and focuses on the natural history, pathophysiology, treatment, and outcome of rheumatic diseases. It is a peer-reviewed publication that aims to provide the highest quality basic and clinical research in this field. The journal covers a wide range of investigative areas and also includes review articles, editorials, and educational material for researchers and clinicians. Being recognized as a leading research journal in rheumatology, Arthritis & Rheumatology serves the global community of rheumatology investigators and clinicians.