Evidence map›Paper›PMID 37289315›Full record

ArticleClinical rheumatology2023

Anaemia is associated with higher disease activity in axial spondyloarthritis but is not an independent predictor of spinal radiographic progression: data from the Swiss Clinical Quality Management Registry.

Raphael Micheroli, Seraphina Kissling, Kristina Bürki, Burkhard Möller, Axel Finckh, Michael J Nissen, Pascale Exer, René Bräm, Diego Kyburz, Andrea Rubbert-Roth and 6 more

Open access · hybridAbstract read
In one paragraph

Article in Clinical rheumatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.5field-weighted citation impact, top 17% 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

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
  2. Article
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.

Raphael MicheroliDepartment of Rheumatology, Zurich University Hospital, University of Zurich, Gloriastrasse 25, CH-8091, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-8918-7304
Seraphina KisslingSwiss Clinical Quality Management Foundation, Zurich, Switzerland.ORCID http://orcid.org/0000-0003-0619-0012
Kristina BürkiDepartment of Rheumatology, Zurich University Hospital, University of Zurich, Gloriastrasse 25, CH-8091, Zurich, Switzerland.
Burkhard MöllerDepartment of Rheumatology and Immunology, Inselspital, Bern, Switzerland.ORCID http://orcid.org/0000-0001-8769-6167
Axel FinckhDepartment of Rheumatology, Geneva University Hospital, Geneva, Switzerland.ORCID http://orcid.org/0000-0002-1210-4347
Michael J NissenDepartment of Rheumatology, Geneva University Hospital, Geneva, Switzerland.ORCID http://orcid.org/0000-0002-6326-1764
Pascale ExerGemeinschaftspraxis Rheuma-Basel, Basel, Switzerland.
René BrämSwiss Ankylosing Spondylitis Association, Zurich, Switzerland.
Diego KyburzDepartment of Rheumatology, University Hospital Basel, University of Basel, Basel, Switzerland.ORCID http://orcid.org/0000-0002-9560-109X
Andrea Rubbert-RothDeparment of Rheumatology, Cantonal Hospital St, Gallen, St. Gallen, Switzerland.
Michael AndorRheumatologie Im Zürcher Oberland, Uster, Switzerland.
Xenofon BaraliakosRheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Bochum, Germany.ORCID http://orcid.org/0000-0002-9475-9362
Manouk de HoogeDepartment of Rheumatology, Ghent University Hospital, Ghent, Belgium.ORCID http://orcid.org/0000-0002-0652-9808
Oliver DistlerDepartment of Rheumatology, Zurich University Hospital, University of Zurich, Gloriastrasse 25, CH-8091, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-0546-8310
Almut SchererSwiss Clinical Quality Management Foundation, Zurich, Switzerland.ORCID http://orcid.org/0000-0001-7382-4092
Adrian CiureaDepartment of Rheumatology, Zurich University Hospital, University of Zurich, Gloriastrasse 25, CH-8091, Zurich, Switzerland. adrian.ciurea@usz.ch.ORCID http://orcid.org/0000-0002-7870-7132
University of Zurich · CHSCQM Foundation · CHUniversity Hospital of Geneva · CHGhent University Hospital · BERheumazentrum Ruhrgebiet · DESwiss Ankylosing Spondylitis Association · CHUniversity Hospital of Bern · CHUniversity of Basel · CHUniversity of St.Gallen · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveAs anaemia represents a biomarker for increased radiographic damage in rheumatoid arthritis, we aimed to investigate whether it independently predicts spinal radiographic progression in axial spondyloarthritis (axSpA).

methodsAxSpA patients with available haemoglobin levels from the prospective Swiss Clinical Quality Management Registry were included for comparison of patients with and without anaemia. Spinal radiographic progression was assessed according to the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) in patients with ankylosing spondylitis (AS) if ≥ 2 sets of spinal radiographs were available every 2 years. The relationship between anaemia and progression (defined as an increase ≥ 2 mSASSS units in 2 years) was analysed with generalized estimating equation models after adjustment for the Ankylosing Spondylitis Disease Activity Score (ASDAS) and potential confounding, as well as after multiple imputations of missing values.

resultsA total of 212/2522 axSpA patients presented with anaemia (9%). Anaemic patients had higher clinical disease activity, higher acute phase reactants and more severe impairments in physical function, mobility and quality of life. In the subgroup of patients with AS (N = 433), a comparable mSASSS progression was found in anaemic and non-anaemic patients (OR 0.69, 95% CI 0.25 to 1.96, p = 0.49). Age, male sex, baseline radiographic damage and ASDAS were associated with enhanced progression. The results were confirmed in complete case analyses and with progression defined as the formation of ≥ 1 syndesmophyte in 2 years.

conclusionAlthough anaemia was associated with higher disease activity in axSpA, it did not additionally contribute to the prediction of spinal radiographic progression. Key Points • Anaemia is associated with higher disease activity and more severely impaired physical function, mobility and quality of life in axSpA. • Anaemia does not provide an additional value to ASDAS for prediction of spinal radiographic progression.

Indexed as

AnemiaSpondylarthritisSpondylitis, AnkylosingDisease ProgressionFemaleHumansMaleProspective StudiesQuality of LifeRegistriesSeverity of Illness IndexSwitzerlandAnaemiaAnkylosing spondylitisAxial spondyloarthritisBiomarkerRadiographic progression

Identifiers

PMID37289315
PMCPMC10412502
OpenAlexW4379768438

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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.