Dr. Märker-Hermann has received consulting fees, speaking fees, and/or honoraria from Abbott, Wyeth, Roche, Chugai, MSD, and Pfizer (less than $10,000 each).
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Spondylarthritis
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Baseline radiographic damage, elevated acute-phase reactant levels, and cigarette smoking status predict spinal radiographic progression in early axial spondylarthritis
Article first published online: 26 APR 2012
DOI: 10.1002/art.33465
Copyright © 2012 by the American College of Rheumatology
Additional Information
How to Cite
Poddubnyy, D., Haibel, H., Listing, J., Märker-Hermann, E., Zeidler, H., Braun, J., Sieper, J. and Rudwaleit, M. (2012), Baseline radiographic damage, elevated acute-phase reactant levels, and cigarette smoking status predict spinal radiographic progression in early axial spondylarthritis. Arthritis & Rheumatism, 64: 1388–1398. doi: 10.1002/art.33465
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Dr. Märker-Hermann has received consulting fees, speaking fees, and/or honoraria from Abbott, Wyeth, Roche, Chugai, MSD, and Pfizer (less than $10,000 each).
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Dr. Braun has received consulting fees, speaking fees, and/or honoraria from Abbott, MSD, Pfizer, and UCB (less than $10,000 each).
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Dr. Rudwaleit has received consulting fees, speaking fees, and/or honoraria from Abbott, Bristol-Myers Squibb, MSD, Pfizer, and UCB (less than $10,000 each).
Publication History
- Issue published online: 26 APR 2012
- Article first published online: 26 APR 2012
- Accepted manuscript online: 29 NOV 2011 03:56PM EST
- Manuscript Accepted: 1 NOV 2011
- Manuscript Received: 27 FEB 2011
Funded by
- German Federal Ministry of Education and Research (BMBF). Grant Number: FKZ 01G19946
- German Competence Network in Rheumatology
- BMBF
- Abbott
- Amgen
- Centocor
- Schering-Plough
- Wyeth
- ANCYLOSS
- ArthroMark projects
- Abstract
- Article
- References
- Cited By
Abstract
Objective
To assess prospectively the rates and to explore predictors of spinal radiographic progression over 2 years in a cohort of patients with early axial spondylarthritis (SpA).
Methods
Two hundred ten patients with axial SpA from the German Spondyloarthritis Inception Cohort were selected for this analysis based on the availability of radiographs at baseline and after 2 years of followup. Spinal radiographs were scored by 2 trained readers in a blinded, randomly selected order according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Spinal radiographic progression was defined as worsening of the mean mSASSS by ≥2 units over 2 years.
Results
Among the patients with axial SpA, 14.3% showed spinal radiographic progression after 2 years (20% of those with AS and 7.4% of those with nonradiographic axial SpA). The following parameters were independently associated with spinal radiographic progression: presence of syndesmophytes at baseline (odds ratio [OR] 6.29, P < 0.001), elevated levels of markers of systemic inflammation (for the erythrocyte sedimentation rate, OR 4.04, P = 0.001; for C-reactive protein level time-averaged over 2 years, OR 3.81, P = 0.001), and cigarette smoking (OR 2.75, P = 0.012). These associations were confirmed by multivariate logistic regression analysis. No clear association with spinal radiographic progression was observed for HLA–B27 status, sex, age, disease duration, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, presence of peripheral arthritis, enthesitis, psoriasis, treatment with nonsteroidal antiinflammatory drugs, or treatment with disease-modifying antirheumatic drugs at baseline.
Conclusion
The presence of radiographic damage at baseline (syndesmophytes), elevated levels of acute-phase reactants, and cigarette smoking were all independently associated with spinal radiographic progression in patients with early axial SpA.