Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Association Between Clinical Factors and Radiographic Severity in Ankylosing Spondylitis.
Kim1, Tae-Jong, Lee2, Seung-Hun, Joo3, Kyung-Bin, Kim4, Tae-Hwan
The most characteristic bony changes in ankylosing spondylitis (AS) are growth of new bone and formation of syndesmophytes, possibly leading to ankylosis and spinal fusion. The objective of this study was to examine the association between clinical factors and radiographic severity in AS
A total of 1000 AS patients who met the modified New York criteria were recruited. To use the modified Stoke AS Spinal Score (mSASSS), cervical and lumbar spinal radiographs were examined by two experienced bone and joint radiologists (KB Joo, SH Lee) to validate the results. The inter-observer variability was also assessed. A review of the clinical parameters was conducted to investigate the associations between clinical factors and the radiographic progression.
The mean age was 35.1(8.7), and the mean disease duration was 11.9(6.9) years. 85.9% were men and 945 patients (94.5%) were HLA-B27 positive. The frequency of juvenile onset AS and peripheral arthritis were 28.1% and 40.7%, respectively. The scores of mSASSS were different between gender (male 22.0±18.9, female 12.6±11.2, p=0.009). As expected, symptom duration has a good relationships with radiographic changes (r=0.412, p<0.001) after age and gender adjusted. The mSASSS of adult onset AS was higher, comparing to Juvenile onset (15.3±10.2, 11.4±8.5, p < 0.05). The patients with peripheral arthritis have lower radiologic scores, comparing to ones without arthritis (11.2±5.2, 16.3±8.5, p < 0.05). Multiple linear regression analysis showed that gender, type of onset, peripheral arthritis, and symptom duration still had an influence on radiographic change score. Unfortunately, no correlations were found between radiographic score and clinical parameters, such as uveitis, B27 positivity, familial history, and use of biologic agent.
Radiographic spinal changes in patients with AS are seen more often in men and those with long symptom duration. Clinical factors such as, juvenile onset AS and peripheral arthritis are negative predictors of radiographic progression in AS. More long term follow up studies are needed to assess the clinical predictors of radiographic change
To cite this abstract, please use the following information:
Kim, Tae-Jong, Lee, Seung-Hun, Joo, Kyung-Bin, Kim, Tae-Hwan; Association Between Clinical Factors and Radiographic Severity in Ankylosing Spondylitis. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :526