Ten-year clinical outcome of recent-onset axial spondyloarthritis: Results from the DESIR inception Cohort - 30/04/24
Highlights |
• | This is the first study describing the 10-year outcome of patients enrolled in an inception cohort of recent-onset axSpA, allowing for a better understanding of the long-term prognosis of these patients. |
• | The long-term outcomes are reassuring with regard to severity outcomes (e.g. need for surgery). |
• | However, the burden of the disease as reflected by patient-reported outcomes seems to still be important, as aa significant percentage of patients (around 50%) do not meet the recommended criteria to be considered as having an acceptable condition (e.g., ASDAS<2.1, for example). |
• | Low disease activity at inclusion, short diagnostic delay and absence of anterior chest-wall pain and a white collar job were found to be predictive to a better disease activity state. |
Abstract |
Objectives |
This study aimed to evaluate the 10-year clinical outcome of patients with recent-onset axial spondyloarthritis (axSpA).
Methods study design |
The DESIR cohort is an inception cohort of axSpA patients.
Methods diagnosis and management |
The diagnosis and management of patients were based on the decision of the treating rheumatologist.
Methods statistical analysis |
Both complete cases and imputed data analyses were conducted.
Results |
Of the 708 enrolled patients, 45 were excluded due to a change in the baseline diagnosis, 3 patients died, and 300 were lost to follow-up over the 10years. In the completer population, one patient required bilateral total hip replacement, and 56 patients received a pension due to invalidity. The prevalence of main extra-musculoskeletal features increased from baseline to year 10: psoriasis from 18% to 30%, acute anterior uveitis from 10% to 18%, and inflammatory bowel disease from 5% to 10%. The most frequent comorbidity was hypertension, with an increase from 5% to 15% from baseline to year 10. In the imputed data analysis the estimated proportions of patients with an acceptable status at year 10 were 70% [95% CI: 63; 77] for acceptable PASS, 43% [95% CI: 37; 49] for BASDAI<3, and 48% [95% CI: 41; 56] for ASDAS<2.1.
Conclusion |
These findings suggest that despite a quite favorable 10-year outcome exists for severe outcomes, a large proportion of patients present with an important disease burden reflected by patient-reported outcomes. This information can be valuable for providing patients with information at the time of diagnosis.
Le texte complet de cet article est disponible en PDF.Keywords : Spondyloarthritis, Cohort, Long-term prognosis
Plan
Vol 91 - N° 3
Article 105678- mai 2024 Retour au numéro
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