Evolution of radiographic damage in ankylosing spondylitis: a 12 year prospective follow-up of the OASIS study
Evolution of radiographic damage in ankylosing spondylitis: a 12 year prospective follow-up of the OASIS study
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DOI：
10.1136/annrheumdis-2013-204055
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发表时间：
2015-01-01
影响因子：
27.4
通讯作者：
Landewe, Robert
中科院分区：
文献类型：
--
作者：
Ramiro, Sofia;Stolwijk, Carmen;Landewe, Robert
目的描述强直性脊柱炎（AS）患者脊柱影像学异常的演变过程。方法对AS患者进行前瞻性随访，每年2次，持续12年。由两名阅片员（R1和R2）对改良的斯托克强直性脊柱炎脊柱评分（mSASSS）进行评分。计算未受累椎体角的新韧带赘生物。影像学进展进行了调查，使用广义估计equations.Results 809 X线片（呈现520在2年的时间间隔）从186例（70%的男性，平均年龄43（SD 12）岁，平均20（SD 12）年，自症状发作和83%的HLA-B27阳性）。基线时平均mSASSS为11.6（16.2）。虽然个体患者的进展过程具有高度可变性，并且仍发生在症状持续时间为数十年的患者中，但平均2年进展为2.0（3.5）mSASSS单位。在整个随访期间，55%（R1）和63%（R2）的患者（所有间期的38%（R1）和39%（R2））至少发现一种新的韧带联合真菌。在24%的患者中（39%的间期），没有进展。22%的患者（或12%的间期）进展>= 5 mSASSS单位。在组水平上，线性时程模型与数据拟合最佳，在整个12年间隔内的恒定速率为0.98 mSASSS单位/年。男性、HLA-B27阳性患者和基线mSASSS ≥ 10的患者的影像学进展明显快于男性。结论AS的长期影像学进展在个体患者中具有高度可变性，HLA-B27阳性男性更为严重，并且在疾病数十年后仍会发生。然而，在组水平上，AS的进展遵循近似线性的过程。
Objectives To describe the evolution of radiographic abnormalities of the spine in patients with ankylosing spondylitis (AS).Methods Patients with AS were followed prospectively with 2 yearly radiographs for 12 years. The modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) was scored by two readers (R1 and R2). New syndesmophytes at uninvolved vertebral corners were computed. Radiographic progression was investigated using generalised estimating equations.Results 809 radiographs (presenting 520 at 2 yearly intervals) from 186 patients (70% men, mean age 43 (SD 12) years, mean 20 (SD 12) years since symptom onset and 83% HLA-B27 positive) were included. Mean mSASSS at baseline was 11.6 (16.2). While the course of progression in individual patients was highly variable, and still occurred in patients with decades of symptom duration, mean 2 year progression was 2.0 (3.5) mSASSS units. Over the entire follow-up, at least one new syndesmophyte was found in 55% (R1) and 63% (R2) of patients (38% (R1) and 39% (R2) of all intervals). In 24% of patients (39% of intervals), there was no progression. A progression >= 5 mSASSS units occurred in 22% of patients (or in 12% of intervals). At the group level, a linear time course model fitted the data best, with a constant rate over the entire 12 year interval of 0.98 mSASSS units/year. Radiographic progression occurred significantly faster in men, in HLA-B27 positive patients and in patients with a baseline mSASSS >= 10.Conclusions Long term radiographic progression in AS is highly variable in the individual patient, more severe in HLA-B27 positive men and still occurs after decades of disease. At the group level, however, progression in AS follows an approximately linear course.