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The degree of spinal inflammation is similar in patients with axial spondyloarthritis who report high or low levels of disease activity: a cohort study
Annals of Rheumatic Diseases, 04/23/2012
Kiltz U et al. – The burden of inflammation is quite comparable in patients with axial spondyloarthritis (axSpA)—regardless of disease activity. These data clearly challenge the concept of the recommended cut–off point of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥4.
Methods- A total of 100 consecutive patients with axSpA who had never been treated with TNF blockers were included.
- Laboratory parameters, spinal MRI and x–rays were quantified.
- Data were stratified according to BASDAI ≥4.
- 44 patients were diagnosed as non–radiographic axSpA (nraxSpA) and 56 patients as ankylosing spondylitis (AS): median age 40.3±10.4 years; 57% male, mean disease duration since diagnosis 6.4±8.4 years, 88% HLA–B27+, mean modified Stokes Ankylosing Spondylitis Spinal Score 8.3±16.4. 60% of patients had spinal inflammation by MRI.
- The stratification based on BASDAI ≥4 disclosed significant differences in most clinical parameters but not for inflammation: patients with nraxSpA and BASDAI <4 versus ≥4 had 0.9±1.4 and 0.5±0.6 inflammatory lesions/patient, respectively (p=0.6), while patients with AS had 3.6±3.7 and 2.7±3.0 inflammatory lesions/patient, respectively (p=0.4).
