Skip to main content

Advertisement

SpringerLink
Log in

Characteristics and burden of disease in patients with radiographic versus non-radiographic axial spondyloarthritis in the ASRI cohort

  • Original Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

Axial spondyloarthritis (axSpA) comprises patients with both radiographic and non-radiographic features. Previous studies have shown similar burden of disease between these two groups.

Aims

The Ankylosing Spondylitis Registry of Ireland (ASRI) was formed with the objective to measure the burden of axial spondyloarthritis in the population and identify early predictors of a poor outcome. For this analysis, the ASRI database was used to compare the characteristics and burden of disease in patients with radiographic versus non-radiographic axial spondyloarthritis.

Methods

Patients with radiographic axial spondyloarthritis (r-axSpA) were defined as those with X-ray evidence of sacroiliitis. Patients with non-radiographic axial spondyloarthritis (nr-axSpA) were defined as having MRI evidence of sacroiliitis but no X-ray evidence of sacroiliitis.

Results

In total, 764 patients were included. Analysis of radiographic status showed 88.1% (n = 673) of patients with r-axSpA and 11.9% (n = 91) with nr-axSpA (Table 1). Patients with nr-axSpA were younger (41.3 vs. 46.6 years, p < 0.01), had shorter disease duration (14.8 vs. 20.2 years, p < 0.01) and had lower proportion of males (66.6% vs. 78.4%, p = 0.02) with lower frequency of HLA-B27 positivity (73.6% vs. 90.5%, p < 0.01). The nr-axSpA group had lower BASDAI (3.37 vs. 4.05, p = 0.01), BASFI (2.46 vs. 3.88, p < 0.01), BASMI (2.33 vs. 4.34, p < 0.01), ASQoL (5.2 vs. 6.67, p = 0.02) and HAQ scores (0.38 vs. 0.57, p < 0.01). There were no significant differences in the prevalence of extra-musculoskeletal manifestations or use of medications.

Conclusions

This study provides evidence to suggest that the burden of disease is less in patients with non-radiographic axial spondyloarthritis than radiographic axial spondyloarthritis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The data that support the findings of this study are available from the corresponding author, (SQ), upon reasonable request.

References

  1. Van der Linden S, Valkenburg HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheumatol 27:361–368

    Article  Google Scholar 

  2. Sieper J, Rudwaleit M, Baraliakos X et al (2009) The Assessment of SpondyloArthritis international Society (ASAS) handbook: a guide to assess spondyloarthritis. Ann Rheum Dis 68(Suppl 2):ii1

  3. Ghosh N, Ruderman EM (2017) Nonradiographic axial spondyloarthritis: clinical and therapeutic relevance. Arthritis Res Ther 19(1):286

    Article  PubMed  PubMed Central  Google Scholar 

  4. Wang R, Gabriel S, Ward M (2016) Progression of nonradiographic axial spondyloarthritis to ankylosing spondylitis: a population-based cohort study. Arthritis Rheumatol 68(6):1415–1421

    Article  PubMed  PubMed Central  Google Scholar 

  5. Van der Heijde D, Ramiro S, Landewe R et al (2017) 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Ann Rheum Dis 76:978–991

    Article  PubMed  Google Scholar 

  6. López-Medina C, Ramiro S, van der Heijde D et al (2019) Characteristics and burden of disease in patients with radiographic and non-radiographic axial Spondyloarthritis: a comparison by systematic literature review and meta-analysis. RMD Open 5(2):e001108

    Article  PubMed  PubMed Central  Google Scholar 

  7. Lee W, Reveille JD, Davis JC, Learch TJ et al (2007) Are there gender differences in severity of ankylosing spondylitis? Results from the PSOAS cohort. Ann Rheum Dis 66(5):633–638

    Article  PubMed  Google Scholar 

  8. Rusman T, van Vollenhoven RF, van der Horst-Bruinsma IE (2018) Gender differences in axial spondyloarthritis: women are not so lucky. Curr Rheumatol Rep 20(6):35–35

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. De Winter JJ, van Mens LJ, van der Heijde D et al (2016) Prevalence of peripheral and extra-articular disease in ankylosing spondylitis versus non-radiographic axial spondyloarthritis: a meta-analysis. Arthritis Res Ther 18(1):196

    Article  PubMed  PubMed Central  Google Scholar 

  10. Van der Linden S, Akkoc N, Brown MA et al (2015) The ASAS criteria for axial spondyloarthritis: strengths, weaknesses, and proposals for a way forward. Curr Rheumatol Rep 17(9):62

    Article  PubMed  Google Scholar 

  11. Rudwaleit M, van der Heijde D, Landewe R et al (2009) The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis 68(6):777–783

    Article  CAS  PubMed  Google Scholar 

  12. Capelusnik D, Cavalieri M, Campuzano RR et al (2018) Uveitis, the most faithful partner of axial spondyloarthritis. Arthritis Rheumatol 70(suppl 10)

  13. Sieper J, Holbrook T, Black CM et al (2016) Burden of illness associated with non-radiographic axial spondyloarthritis: a multiperspective European cross-sectional observational study. Clin Exp Rheumatol 34:975–983

    PubMed  Google Scholar 

  14. Karmacharya P, Duarte-Garcia A, Dubreuil M et al (2020) Effect of therapy on radiographic progression in axial spondyloarthritis: a systematic review and meta-analysis. Arthritis Rheumatol 72(5):733–749

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Kiltz U, Baraliakos X, Karakostas P et al (2012) Do patients with non-radiographic axial spondylarthritis differ from patients with ankylosing spondylitis? Arthritis Care Res (Hoboken) 64(9):1415–1422

    Article  PubMed  Google Scholar 

Download references

Funding

The Ankylosing Spondylitis Registry of Ireland (ASRI) is supported by an unrestricted grant from Pfizer Pharmaceuticals and AbbVie Pharmaceuticals. The funders had no role in the design of the study, collection of the data, analysis and interpretation of the data, or any part of manuscript preparation.

Author information

Authors and Affiliations

  1. Rheumatology Department, St Vincent’s University Hospital, Elm Park, Dublin 4, Ireland

    Sean Quinn, Lorraine O’Neill, Eamonn Molloy & Phil Gallagher

  2. Rheumatology Department, St James’ Hospital, Dublin 8, Ireland

    Sinead Maguire & Finbar O’Shea

  3. Molecular Rheumatology, Trinity Biomedical Sciences Institute, Pearse St., Dublin 2, Ireland

    Ursula Fearon

  4. The EULAR Centre for Arthritis and Rheumatic Disease, St Vincent’s University Hospital, Elm Park and University College Dublin, Dublin 4, Ireland

    Douglas J. Veale

Authors
  1. Sean Quinn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sinead Maguire
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Finbar O’Shea
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lorraine O’Neill
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eamonn Molloy
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ursula Fearon
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Phil Gallagher
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Douglas J. Veale
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors whose names appear on the submission made substantial contributions to the conception or design of the work; or the acquisition, analysis or interpretation of data; or the creation of new software used in the work; drafted the work or revised it critically for important intellectual content; approved the version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Sean Quinn.

Ethics declarations

Ethics approval

The required ethical approval was gained from all participating hospital ethics boards and are in line with the 1964 Helsinki Declaration and its later amendments.

Consent to participate

Informed consent was obtained from all participants in the ASRI cohort for this study.

Conflict of interests

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Key messages:

• This study suggests the burden of disease is greater in patients with r-axSpA than nr-axSpA.

• Greater burden of disease in r-axSpA may provide extra impetus to institute early treatment.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Quinn, S., Maguire, S., O’Shea, F. et al. Characteristics and burden of disease in patients with radiographic versus non-radiographic axial spondyloarthritis in the ASRI cohort. Ir J Med Sci 193, 443–448 (2024). https://doi.org/10.1007/s11845-023-03439-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-023-03439-x

Keywords

Search

Navigation