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Brief Report: Clinical Course Over Two Years in Patients With Early Nonradiographic Axial Spondyloarthritis and Patients With Ankylosing Spondylitis Not Treated With Tumor Necrosis Factor Blockers: Results From the German Spondyloarthritis Inception Cohort.
Arthritis Rheumatol. 2015 Sep; 67(9):2369-75.AR

Abstract

OBJECTIVE

To investigate the clinical course of disease over 2 years in patients with nonradiographic axial spondylarthritis (SpA) and patients with ankylosing spondylitis (AS).

METHODS

The study group comprised 303 patients with axial SpA (158 patients with AS and a symptom duration of ≤10 years and 145 patients with nonradiographic axial SpA and a symptom duration of ≤5 years) who did not receive tumor necrosis factor (TNF) blockers during 2 years of followup.

RESULTS

The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) did not differ between patients with nonradiographic axial SpA and those with AS at any time point during followup. The Bath Ankylosing Spondylitis Functional Index was significantly higher in patients with AS at baseline only, but spinal mobility was generally better in patients with nonradiographic SpA compared with those with AS. At all time points, C-reactive protein (CRP) levels were significantly higher in patients with AS compared with patients with nonradiographic axial SpA. Accordingly, the Ankylosing Spondylitis Disease Activity Score (ASDAS) was significantly higher in the patients with AS at 2 of 4 time points. When patients with a BASDAI score of ≥4 plus an elevated CRP level at baseline were analyzed over time, there were no significant differences in the proportions of patients with nonradiographic axial SpA and those with AS who reached low disease activity status at ≥2 time points during 2 years of followup when a clinical definition of low disease activity was used (38% and 35%, respectively, achieved a BASDAI score of <4, and 13% and 15%, respectively, achieved a score of ≤2). When definitions that included the CRP level were used, however, a greater percentage of patients with nonradiographic axial SpA achieved low disease activity (25% of patients with nonradiographic axial SpA and 10% of patients with AS achieved a BASDAI score of <4 and a normal CRP level, and 13% of patients with nonradiographic axial SpA and 3% of those with AS achieved ASDAS-defined low disease activity).

CONCLUSION

Patients with nonradiographic axial SpA and those with AS who were not treated with TNF blockers demonstrated a similar clinical disease course over 2 years. Patients with nonradiographic axial SpA achieved a status of low disease activity more frequently than those with AS if outcome parameters that included the CRP level were used.

Authors+Show Affiliations

Charité Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany.Charité Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany.Rheumazentrum Ruhrgebiet, Herne, Germany.Klinikum Bielefeld Rosenhöhe, Bielefeld, Germany.Charité Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26017497

Citation

Poddubnyy, Denis, et al. "Brief Report: Clinical Course Over Two Years in Patients With Early Nonradiographic Axial Spondyloarthritis and Patients With Ankylosing Spondylitis Not Treated With Tumor Necrosis Factor Blockers: Results From the German Spondyloarthritis Inception Cohort." Arthritis & Rheumatology (Hoboken, N.J.), vol. 67, no. 9, 2015, pp. 2369-75.
Poddubnyy D, Haibel H, Braun J, et al. Brief Report: Clinical Course Over Two Years in Patients With Early Nonradiographic Axial Spondyloarthritis and Patients With Ankylosing Spondylitis Not Treated With Tumor Necrosis Factor Blockers: Results From the German Spondyloarthritis Inception Cohort. Arthritis & rheumatology (Hoboken, N.J.). 2015;67(9):2369-75.
Poddubnyy, D., Haibel, H., Braun, J., Rudwaleit, M., & Sieper, J. (2015). Brief Report: Clinical Course Over Two Years in Patients With Early Nonradiographic Axial Spondyloarthritis and Patients With Ankylosing Spondylitis Not Treated With Tumor Necrosis Factor Blockers: Results From the German Spondyloarthritis Inception Cohort. Arthritis & Rheumatology (Hoboken, N.J.), 67(9), 2369-75. https://doi.org/10.1002/art.39225
Poddubnyy D, et al. Brief Report: Clinical Course Over Two Years in Patients With Early Nonradiographic Axial Spondyloarthritis and Patients With Ankylosing Spondylitis Not Treated With Tumor Necrosis Factor Blockers: Results From the German Spondyloarthritis Inception Cohort. Arthritis & rheumatology (Hoboken, N.J.). 2015;67(9):2369-75. PubMed PMID: 26017497.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Brief Report: Clinical Course Over Two Years in Patients With Early Nonradiographic Axial Spondyloarthritis and Patients With Ankylosing Spondylitis Not Treated With Tumor Necrosis Factor Blockers: Results From the German Spondyloarthritis Inception Cohort. AU - Poddubnyy,Denis, AU - Haibel,Hildrun, AU - Braun,Jürgen, AU - Rudwaleit,Martin, AU - Sieper,Joachim, PY - 2015/01/09/received PY - 2015/05/26/accepted PY - 2015/5/29/entrez PY - 2015/5/29/pubmed PY - 2015/11/17/medline SP - 2369 EP - 75 JF - Arthritis & rheumatology (Hoboken, N.J.) VL - 67 IS - 9 N2 - OBJECTIVE: To investigate the clinical course of disease over 2 years in patients with nonradiographic axial spondylarthritis (SpA) and patients with ankylosing spondylitis (AS). METHODS: The study group comprised 303 patients with axial SpA (158 patients with AS and a symptom duration of ≤10 years and 145 patients with nonradiographic axial SpA and a symptom duration of ≤5 years) who did not receive tumor necrosis factor (TNF) blockers during 2 years of followup. RESULTS: The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) did not differ between patients with nonradiographic axial SpA and those with AS at any time point during followup. The Bath Ankylosing Spondylitis Functional Index was significantly higher in patients with AS at baseline only, but spinal mobility was generally better in patients with nonradiographic SpA compared with those with AS. At all time points, C-reactive protein (CRP) levels were significantly higher in patients with AS compared with patients with nonradiographic axial SpA. Accordingly, the Ankylosing Spondylitis Disease Activity Score (ASDAS) was significantly higher in the patients with AS at 2 of 4 time points. When patients with a BASDAI score of ≥4 plus an elevated CRP level at baseline were analyzed over time, there were no significant differences in the proportions of patients with nonradiographic axial SpA and those with AS who reached low disease activity status at ≥2 time points during 2 years of followup when a clinical definition of low disease activity was used (38% and 35%, respectively, achieved a BASDAI score of <4, and 13% and 15%, respectively, achieved a score of ≤2). When definitions that included the CRP level were used, however, a greater percentage of patients with nonradiographic axial SpA achieved low disease activity (25% of patients with nonradiographic axial SpA and 10% of patients with AS achieved a BASDAI score of <4 and a normal CRP level, and 13% of patients with nonradiographic axial SpA and 3% of those with AS achieved ASDAS-defined low disease activity). CONCLUSION: Patients with nonradiographic axial SpA and those with AS who were not treated with TNF blockers demonstrated a similar clinical disease course over 2 years. Patients with nonradiographic axial SpA achieved a status of low disease activity more frequently than those with AS if outcome parameters that included the CRP level were used. SN - 2326-5205 UR - https://www.unboundmedicine.com/medline/citation/26017497/Brief_Report:_Clinical_Course_Over_Two_Years_in_Patients_With_Early_Nonradiographic_Axial_Spondyloarthritis_and_Patients_With_Ankylosing_Spondylitis_Not_Treated_With_Tumor_Necrosis_Factor_Blockers:_Results_From_the_German_Spondyloarthritis_Inception_Cohort_ L2 - https://doi.org/10.1002/art.39225 DB - PRIME DP - Unbound Medicine ER -