David Kiefer, Imke Redeker, Murat Torgutalp, Valeria Rios Rodriguez, Judith Rademacher, Fabian Proft, Mikhail Protopopov, Hildrun Haibel, Joachim Sieper, Martin Rudwaleit, Xenofon Baraliakos, Denis Poddubnyy
{"title":"诊断时早期轴性脊柱炎状态与疾病活动性的纵向关联：来自GESPIC队列的10年结果","authors":"David Kiefer, Imke Redeker, Murat Torgutalp, Valeria Rios Rodriguez, Judith Rademacher, Fabian Proft, Mikhail Protopopov, Hildrun Haibel, Joachim Sieper, Martin Rudwaleit, Xenofon Baraliakos, Denis Poddubnyy","doi":"10.1136/rmdopen-2025-005948","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Recently, the definition for 'early axial spondyloarthritis (axSpA)' was developed by the Assessment of SpondyloArthritis international Society (ASAS), including ≤2 years of axial symptoms as a key element. The aim of this study was to analyse the longitudinal association of early axSpA with achieving low disease activity or inactive disease.</p><p><strong>Methods: </strong>Using 10-year longitudinal data from the German Spondyloarthritis Inception Cohort (GESPIC), a generalised estimating equations model was fitted to estimate the effect of early axSpA on disease activity, as measured by the Axial Spondyloarthritis Disease Activity Score (ASDAS). The model adjusted for confounders identified through a directed acyclic graph and accounted for repeated measurements within patients. Additional analyses were conducted, including stratification by radiographic status (non-radiographic-nr or radiographic-r).</p><p><strong>Results: </strong>Of 525 patients (277 nr-axSpA, 248 r-axSpA) included in GESPIC, 161 (30%) fulfilled the ASAS early axSpA consensus definition (115 nr-axSpA and 46 r-axSpA) at baseline. Over the 10-year follow-up period, patients with early axSpA consistently achieved ASDAS states of inactive disease or low disease activity at a higher rate than those with non-early axSpA, rising from 41% versus 30% at baseline to 57% versus 44% at year 10. The total effect of early axSpA on ASDAS was -0.42 (95% CI: -0.57 to -0.26). Stratification by r-axSpA/nr-axSpA showed a total effect of -0.50 (95% CI: -0.81 to -0.19) for r-axSpA and -0.28 (95% CI: -0.46 to -0.10) for nr-axSpA.</p><p><strong>Conclusion: </strong>Fulfilment of the ASAS early axSpA definition at inclusion was associated with lower disease activity over 10 years.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 3","pages":""},"PeriodicalIF":4.7000,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12458802/pdf/","citationCount":"0","resultStr":"{\"title\":\"Longitudinal association of early axial spondyloarthritis status at the time of diagnosis with disease activity over time: 10-year results from the GESPIC cohort.\",\"authors\":\"David Kiefer, Imke Redeker, Murat Torgutalp, Valeria Rios Rodriguez, Judith Rademacher, Fabian Proft, Mikhail Protopopov, Hildrun Haibel, Joachim Sieper, Martin Rudwaleit, Xenofon Baraliakos, Denis Poddubnyy\",\"doi\":\"10.1136/rmdopen-2025-005948\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Recently, the definition for 'early axial spondyloarthritis (axSpA)' was developed by the Assessment of SpondyloArthritis international Society (ASAS), including ≤2 years of axial symptoms as a key element. The aim of this study was to analyse the longitudinal association of early axSpA with achieving low disease activity or inactive disease.</p><p><strong>Methods: </strong>Using 10-year longitudinal data from the German Spondyloarthritis Inception Cohort (GESPIC), a generalised estimating equations model was fitted to estimate the effect of early axSpA on disease activity, as measured by the Axial Spondyloarthritis Disease Activity Score (ASDAS). The model adjusted for confounders identified through a directed acyclic graph and accounted for repeated measurements within patients. Additional analyses were conducted, including stratification by radiographic status (non-radiographic-nr or radiographic-r).</p><p><strong>Results: </strong>Of 525 patients (277 nr-axSpA, 248 r-axSpA) included in GESPIC, 161 (30%) fulfilled the ASAS early axSpA consensus definition (115 nr-axSpA and 46 r-axSpA) at baseline. Over the 10-year follow-up period, patients with early axSpA consistently achieved ASDAS states of inactive disease or low disease activity at a higher rate than those with non-early axSpA, rising from 41% versus 30% at baseline to 57% versus 44% at year 10. The total effect of early axSpA on ASDAS was -0.42 (95% CI: -0.57 to -0.26). Stratification by r-axSpA/nr-axSpA showed a total effect of -0.50 (95% CI: -0.81 to -0.19) for r-axSpA and -0.28 (95% CI: -0.46 to -0.10) for nr-axSpA.</p><p><strong>Conclusion: </strong>Fulfilment of the ASAS early axSpA definition at inclusion was associated with lower disease activity over 10 years.</p>\",\"PeriodicalId\":21396,\"journal\":{\"name\":\"RMD Open\",\"volume\":\"11 3\",\"pages\":\"\"},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2025-09-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12458802/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"RMD Open\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/rmdopen-2025-005948\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"RMD Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/rmdopen-2025-005948","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
Longitudinal association of early axial spondyloarthritis status at the time of diagnosis with disease activity over time: 10-year results from the GESPIC cohort.
Objective: Recently, the definition for 'early axial spondyloarthritis (axSpA)' was developed by the Assessment of SpondyloArthritis international Society (ASAS), including ≤2 years of axial symptoms as a key element. The aim of this study was to analyse the longitudinal association of early axSpA with achieving low disease activity or inactive disease.
Methods: Using 10-year longitudinal data from the German Spondyloarthritis Inception Cohort (GESPIC), a generalised estimating equations model was fitted to estimate the effect of early axSpA on disease activity, as measured by the Axial Spondyloarthritis Disease Activity Score (ASDAS). The model adjusted for confounders identified through a directed acyclic graph and accounted for repeated measurements within patients. Additional analyses were conducted, including stratification by radiographic status (non-radiographic-nr or radiographic-r).
Results: Of 525 patients (277 nr-axSpA, 248 r-axSpA) included in GESPIC, 161 (30%) fulfilled the ASAS early axSpA consensus definition (115 nr-axSpA and 46 r-axSpA) at baseline. Over the 10-year follow-up period, patients with early axSpA consistently achieved ASDAS states of inactive disease or low disease activity at a higher rate than those with non-early axSpA, rising from 41% versus 30% at baseline to 57% versus 44% at year 10. The total effect of early axSpA on ASDAS was -0.42 (95% CI: -0.57 to -0.26). Stratification by r-axSpA/nr-axSpA showed a total effect of -0.50 (95% CI: -0.81 to -0.19) for r-axSpA and -0.28 (95% CI: -0.46 to -0.10) for nr-axSpA.
Conclusion: Fulfilment of the ASAS early axSpA definition at inclusion was associated with lower disease activity over 10 years.
期刊介绍：
RMD Open publishes high quality peer-reviewed original research covering the full spectrum of musculoskeletal disorders, rheumatism and connective tissue diseases, including osteoporosis, spine and rehabilitation. Clinical and epidemiological research, basic and translational medicine, interesting clinical cases, and smaller studies that add to the literature are all considered.
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