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Comparison of patients with ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA) from a single rheumatology clinic in New Delhi.
Int J Rheum Dis 2015; 18(7):736-41IJ

Abstract

AIM

Comparison of ankylosing spondylitis (AS) with non-radiographic axial spondyloarthritis (nr-axSpA) classified with the recent ASsessment of spondyloArthritis International Society (ASAS) criteria.

PATIENTS & METHODS

This study included 288 patients clinically diagnosed as having spondyloarthritis (SpA) where a satisfactory radiograph of sacroiliac (S-I) joints was available. The AS and the nr-axSpA groups were compared for the various SpA-related variables.

RESULTS

Of 288 axSpA patients, there were 187 with AS. Of the remaining 101 patients without radiographic sacroiliitis, S-I joint magnetic resonance imaging (MRI) was available in 72; 54 of them showed active sacroiliitis thus classified as nr-axSpA according to the ASAS criteria. The remaining 18 patients with normal MRI and the other 29 patients without MRI of the S-I joints (total 47 patients), were classified as nr-axSpA using the 'clinical arm' of the ASAS criteria. On comparing the 187 AS with 101 patients in the nr-axSpA group, the AS group showed significantly more males, longer disease duration, more axial symptoms at disease onset, higher Bath Ankylosing Spondylitis Metrology Index and more syndesmophytes. Biologicals were offered significantly more often to the AS group but methotrexate as monotherapy or in combination with other disease-modifying anti-rheumatic drugs was offered more often in nr-axSpA group. There was no statistically significant difference between AS and nr-axSpA in other SpA parameters.

CONCLUSION

The differences brought out between AS and nr-axSpA groups show that they may not be the same disease. A prospective long-term follow-up of large cohorts may help in clarifying if nr-axSpA is simply an early stage in the spectrum of SpA evolving into AS over time or is there inherent difference between them.

Authors+Show Affiliations

'A&R Clinic' for Arthritis and Rheumatism, New Delhi, India. Department of Rheumatology, ISIC Superspeciality Hospital, New Delhi, India.Department of Rheumatology, ISIC Superspeciality Hospital, New Delhi, India.Department of Rheumatology, ISIC Superspeciality Hospital, New Delhi, India.Department of Rheumatology, ISIC Superspeciality Hospital, New Delhi, India.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

26172961

Citation

Malaviya, Anand N., et al. "Comparison of Patients With Ankylosing Spondylitis (AS) and Non-radiographic Axial Spondyloarthritis (nr-axSpA) From a Single Rheumatology Clinic in New Delhi." International Journal of Rheumatic Diseases, vol. 18, no. 7, 2015, pp. 736-41.
Malaviya AN, Kalyani A, Rawat R, et al. Comparison of patients with ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA) from a single rheumatology clinic in New Delhi. Int J Rheum Dis. 2015;18(7):736-41.
Malaviya, A. N., Kalyani, A., Rawat, R., & Gogia, S. B. (2015). Comparison of patients with ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA) from a single rheumatology clinic in New Delhi. International Journal of Rheumatic Diseases, 18(7), pp. 736-41. doi:10.1111/1756-185X.12579.
Malaviya AN, et al. Comparison of Patients With Ankylosing Spondylitis (AS) and Non-radiographic Axial Spondyloarthritis (nr-axSpA) From a Single Rheumatology Clinic in New Delhi. Int J Rheum Dis. 2015;18(7):736-41. PubMed PMID: 26172961.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of patients with ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA) from a single rheumatology clinic in New Delhi. AU - Malaviya,Anand N, AU - Kalyani,Alok, AU - Rawat,Roopa, AU - Gogia,Shashi Bhushan, Y1 - 2015/07/14/ PY - 2015/7/15/entrez PY - 2015/7/15/pubmed PY - 2016/6/9/medline KW - Assessment of Ankylosing Spondylitis International Society criteria KW - ankylosing spondylitis KW - axial-spondyloarthritis KW - modified New York criteria KW - non-radiographic spondyloarthritis SP - 736 EP - 41 JF - International journal of rheumatic diseases JO - Int J Rheum Dis VL - 18 IS - 7 N2 - AIM: Comparison of ankylosing spondylitis (AS) with non-radiographic axial spondyloarthritis (nr-axSpA) classified with the recent ASsessment of spondyloArthritis International Society (ASAS) criteria. PATIENTS & METHODS: This study included 288 patients clinically diagnosed as having spondyloarthritis (SpA) where a satisfactory radiograph of sacroiliac (S-I) joints was available. The AS and the nr-axSpA groups were compared for the various SpA-related variables. RESULTS: Of 288 axSpA patients, there were 187 with AS. Of the remaining 101 patients without radiographic sacroiliitis, S-I joint magnetic resonance imaging (MRI) was available in 72; 54 of them showed active sacroiliitis thus classified as nr-axSpA according to the ASAS criteria. The remaining 18 patients with normal MRI and the other 29 patients without MRI of the S-I joints (total 47 patients), were classified as nr-axSpA using the 'clinical arm' of the ASAS criteria. On comparing the 187 AS with 101 patients in the nr-axSpA group, the AS group showed significantly more males, longer disease duration, more axial symptoms at disease onset, higher Bath Ankylosing Spondylitis Metrology Index and more syndesmophytes. Biologicals were offered significantly more often to the AS group but methotrexate as monotherapy or in combination with other disease-modifying anti-rheumatic drugs was offered more often in nr-axSpA group. There was no statistically significant difference between AS and nr-axSpA in other SpA parameters. CONCLUSION: The differences brought out between AS and nr-axSpA groups show that they may not be the same disease. A prospective long-term follow-up of large cohorts may help in clarifying if nr-axSpA is simply an early stage in the spectrum of SpA evolving into AS over time or is there inherent difference between them. SN - 1756-185X UR - https://www.unboundmedicine.com/medline/citation/26172961/Comparison_of_patients_with_ankylosing_spondylitis__AS__and_non_radiographic_axial_spondyloarthritis__nr_axSpA__from_a_single_rheumatology_clinic_in_New_Delhi_ L2 - https://doi.org/10.1111/1756-185X.12579 DB - PRIME DP - Unbound Medicine ER -