A five-year prospective study of spinal radiographic progression and its predictors in men and women with ankylosing spondylitis
Abstract Background Knowledge about predictors of new spinal bone formation in patients with ankylosing spondylitis (AS) is limited. AS-related spinal alterations are more common in men; however, knowledge of whether predictors differ between sexes is lacking. Our objectives were to study spinal rad...
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doaj-6bce379d18294e24a1d2949025a7af4e2020-11-24T22:00:37ZengBMCArthritis Research & Therapy1478-63622018-08-0120111410.1186/s13075-018-1665-1A five-year prospective study of spinal radiographic progression and its predictors in men and women with ankylosing spondylitisAnna Deminger0Eva Klingberg1Mats Geijer2Jan Göthlin3Martin Hedberg4Eva Rehnberg5Hans Carlsten6Lennart T. Jacobsson7Helena Forsblad-d’Elia8Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of GothenburgDepartment of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of GothenburgDepartment of Radiology, Skåne University HospitalDepartment of Radiology, Sahlgrenska University HospitalSection of Rheumatology, Södra Älvsborg HospitalSection of Rheumatology, Alingsås HospitalDepartment of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of GothenburgDepartment of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of GothenburgDepartment of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of GothenburgAbstract Background Knowledge about predictors of new spinal bone formation in patients with ankylosing spondylitis (AS) is limited. AS-related spinal alterations are more common in men; however, knowledge of whether predictors differ between sexes is lacking. Our objectives were to study spinal radiographic progression in patients with AS and investigate predictors of progression overall and by sex. Methods Swedish patients with AS, age (mean ± SD) 50 ± 13 years, were included in a longitudinal study. At baseline and at 5-year follow up, spinal radiographs were graded according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Predictors were assessed by questionnaires, spinal mobility tests and blood samples. Results Of 204 patients included, 166 (81%) were re-examined and 54% were men. Men had significantly higher mean mSASSS at baseline and higher mean increase in mSASSS than women (1.9 ± 2.8 vs. 1.2 ± 3.3; p = 0.005) More men than women developed new syndesmophytes (30% vs. 12%; p = 0.007). Multivariate logistic regression analyses with progression ≥ 2 mSASSS units over 5 years or development of new syndesmophytes as the dependent variable showed that presence of baseline AS-related spinal radiographic alterations and obesity (OR 3.78, 95% CI 1.3 to 11.2) were independent predictors of spinal radiographic progression in both sexes. High C-reactive protein (CRP) was a significant predictor in men, with only a trend seen in women. Smoking predicted progression in men whereas high Bath Ankylosing Spondylitis Metrology Index (BASMI) and exposure to bisphosphonates during follow up (OR 4.78, 95% CI 1.1 to 20.1) predicted progression in women. Conclusion This first report on sex-specific predictors of spinal radiographic progression shows that predictors may partly differ between the sexes. New predictors identified were obesity in both sexes and exposure to bisphosphonates in women. Among previously known predictors, baseline AS-related spinal radiographic alterations predicted radiographic progression in both sexes, high CRP was a predictor in men (with a trend in women) and smoking was a predictor only in men. Trial registration ClinicalTrials.gov, NCT00858819. Registered on 9 March 2009. Last updated 28 May 2015.http://link.springer.com/article/10.1186/s13075-018-1665-1Ankylosing spondylitisOutcomes researchTreatmentInflammationLongitudinal studyRadiography |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Anna Deminger Eva Klingberg Mats Geijer Jan Göthlin Martin Hedberg Eva Rehnberg Hans Carlsten Lennart T. Jacobsson Helena Forsblad-d’Elia |
spellingShingle |
Anna Deminger Eva Klingberg Mats Geijer Jan Göthlin Martin Hedberg Eva Rehnberg Hans Carlsten Lennart T. Jacobsson Helena Forsblad-d’Elia A five-year prospective study of spinal radiographic progression and its predictors in men and women with ankylosing spondylitis Arthritis Research & Therapy Ankylosing spondylitis Outcomes research Treatment Inflammation Longitudinal study Radiography |
author_facet |
Anna Deminger Eva Klingberg Mats Geijer Jan Göthlin Martin Hedberg Eva Rehnberg Hans Carlsten Lennart T. Jacobsson Helena Forsblad-d’Elia |
author_sort |
Anna Deminger |
title |
A five-year prospective study of spinal radiographic progression and its predictors in men and women with ankylosing spondylitis |
title_short |
A five-year prospective study of spinal radiographic progression and its predictors in men and women with ankylosing spondylitis |
title_full |
A five-year prospective study of spinal radiographic progression and its predictors in men and women with ankylosing spondylitis |
title_fullStr |
A five-year prospective study of spinal radiographic progression and its predictors in men and women with ankylosing spondylitis |
title_full_unstemmed |
A five-year prospective study of spinal radiographic progression and its predictors in men and women with ankylosing spondylitis |
title_sort |
five-year prospective study of spinal radiographic progression and its predictors in men and women with ankylosing spondylitis |
publisher |
BMC |
series |
Arthritis Research & Therapy |
issn |
1478-6362 |
publishDate |
2018-08-01 |
description |
Abstract Background Knowledge about predictors of new spinal bone formation in patients with ankylosing spondylitis (AS) is limited. AS-related spinal alterations are more common in men; however, knowledge of whether predictors differ between sexes is lacking. Our objectives were to study spinal radiographic progression in patients with AS and investigate predictors of progression overall and by sex. Methods Swedish patients with AS, age (mean ± SD) 50 ± 13 years, were included in a longitudinal study. At baseline and at 5-year follow up, spinal radiographs were graded according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Predictors were assessed by questionnaires, spinal mobility tests and blood samples. Results Of 204 patients included, 166 (81%) were re-examined and 54% were men. Men had significantly higher mean mSASSS at baseline and higher mean increase in mSASSS than women (1.9 ± 2.8 vs. 1.2 ± 3.3; p = 0.005) More men than women developed new syndesmophytes (30% vs. 12%; p = 0.007). Multivariate logistic regression analyses with progression ≥ 2 mSASSS units over 5 years or development of new syndesmophytes as the dependent variable showed that presence of baseline AS-related spinal radiographic alterations and obesity (OR 3.78, 95% CI 1.3 to 11.2) were independent predictors of spinal radiographic progression in both sexes. High C-reactive protein (CRP) was a significant predictor in men, with only a trend seen in women. Smoking predicted progression in men whereas high Bath Ankylosing Spondylitis Metrology Index (BASMI) and exposure to bisphosphonates during follow up (OR 4.78, 95% CI 1.1 to 20.1) predicted progression in women. Conclusion This first report on sex-specific predictors of spinal radiographic progression shows that predictors may partly differ between the sexes. New predictors identified were obesity in both sexes and exposure to bisphosphonates in women. Among previously known predictors, baseline AS-related spinal radiographic alterations predicted radiographic progression in both sexes, high CRP was a predictor in men (with a trend in women) and smoking was a predictor only in men. Trial registration ClinicalTrials.gov, NCT00858819. Registered on 9 March 2009. Last updated 28 May 2015. |
topic |
Ankylosing spondylitis Outcomes research Treatment Inflammation Longitudinal study Radiography |
url |
http://link.springer.com/article/10.1186/s13075-018-1665-1 |
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