Evidence map›Paper›PMID 35110365›Full record

Observational studyRMD open2022

Current differentiation between radiographic and non-radiographic axial spondyloarthritis is of limited benefit for prediction of important clinical outcomes: data from a large, prospective, observational cohort.

Adrian Ciurea, Seraphina Kissling, Kristina Bürki, Xenofon Baraliakos, Manouk de Hooge, Monika Hebeisen, Eleftherios Papagiannoulis, Pascale Exer, René Bräm, Michael J Nissen and 6 more

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in RMD open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
2.9field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 18 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 9 institutions in 3 countries.

Adrian CiureaDepartment of Rheumatology, Zurich University Hospital, University of Zurich, Zurich, Switzerland adrian.ciurea@usz.ch.ORCID 0000-0002-7870-7132
Seraphina KisslingSwiss Clinical Quality Management Foundation, Zurich, Switzerland.
Kristina BürkiDepartment of Rheumatology, Zurich University Hospital, University of Zurich, Zurich, Switzerland.
Xenofon BaraliakosRheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Bochum, Germany.ORCID 0000-0002-9475-9362
Manouk de HoogeVIB Inflammation Research Center, Ghent University, Ghent, Belgium.
Monika HebeisenSCQM Foundation, Zurich, Switzerland.
Eleftherios PapagiannoulisSCQM Foundation, Zurich, Switzerland.
Pascale ExerPraxis Rheuma-Basel, Basel, Switzerland.
René BrämSwiss Ankylosing Spondylitis Association, Zurich, Switzerland.
Michael J NissenDivision of Rheumatology, Geneva University Hospital, Geneva, Switzerland.
Burkhard MöllerDepartment of Rheumatology, Inselspital Bern, Bern, Switzerland.
Diego KyburzDepartment of Rheumatology, Basel University Hospital, Basel, Switzerland.
Michael AndorPrivate Rheumatology Practice, Uster, Switzerland.
Oliver DistlerDepartment of Rheumatology, Zurich University Hospital, University of Zurich, Zurich, Switzerland.
Almut SchererSwiss Clinical Quality Management in Rheumatic Diseases SCQM, Zurich, Switzerland.
Raphael MicheroliDepartment of Rheumatology, Zurich University Hospital, University of Zurich, Zurich, Switzerland.ORCID 0000-0002-8918-7304
SCQM Foundation · CHUniversity of Zurich · CHGhent University · BERheumazentrum Ruhrgebiet · DESpital Uster · CHSwiss Ankylosing Spondylitis Association · CHUniversity Hospital of Basel · CHUniversity Hospital of Bern · CHUniversity Hospital of Geneva · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare disease characteristics and outcomes between patients with axial spondyloarthritis with non-radiographic disease (nr-axSpA), bilateral grade 2 sacroiliitis (r22axSpA) and unilateral/bilateral grade 3-4 sacroiliitis (r3+axSpA) according to the modified New York criteria.

methodsWe included patients with axial spondyloarthritis with available pelvic radiographs from the Swiss Clinical Quality Management Cohort. Retention of a first tumour necrosis factor inhibitor (TNFi) was investigated with multiple adjusted Cox proportional hazards models. The proportion of patients reaching 50% reduction in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI50) at 1 year was assessed with multiple adjusted logistic regression analyses. Spinal radiographic progression, defined as an increase in ≥2 mSASSS units in 2 years, was assessed in generalised estimating equation models.

resultsFrom 2080 patients, those with nr-axSpA (n=485) and r22axSpA (n=443) presented with lower C reactive protein levels and less severe clinical spinal involvement compared with patients with r3+axSpA (n=1152). While TNFi retention was similar in r22axSpA and nr-axSpA, the risk of discontinuation was significantly lower in r3+axSpA (HR 0.60, 95% CI 0.44 to 0.82 vs nr-axSpA). BASDAI50 responses at 1 year were comparable in r22axSpA and nr-axSpA, with a better response associated with r3+axSpA (OR 2.05, 95% CI 1.09 to 3.91 vs nr-axSpA). Spinal radiographic progression was similar in r22axSpA and nr-axSpA and significantly higher in r3 +axSpA.

conclusionPatients with r22axSpA are comparable to nr-axSpA patients but differ from patients with more severe sacroiliac damage with regard to treatment effectiveness and spinal radiographic progression. Therefore, current differentiation between nr-axSpA and radiographic disease seems of limited use for outcome prediction.

Indexed as

Axial SpondyloarthritisSpondylarthritisSpondylitis, AnkylosingHumansProspective StudiesSeverity of Illness Indexankylosingepidemiologyspondylitistumor necrosis factor inhibitors

Identifiers

PMID35110365
PMCPMC8811599
OpenAlexW4210787552

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.