Axial Psoriatic Arthritis: Update on a Longterm Prospective Study
Open Access
- 2 November 2009
- journal article
- Published by The Journal of Rheumatology in The Journal of Rheumatology
- Vol. 36 (12), 2744-2750
- https://doi.org/10.3899/jrheum.090412
Abstract
Objective. To evaluate changes in symptoms, spinal mobility, and radiographic features in patients with axial psoriatic arthritis (AxPsA). Methods. Patients with AxPsA were identified from the University of Toronto Psoriatic Arthritis clinic database. Axial symptoms, metrology, and radiographic features at study entry were compared to 5-year and 10-year followup assessments. Data were analyzed using continuity adjusted McNemar’s test, an exact binomial test, or logistic regression. Results. Of 297 patients (mean age 42.5 yrs, PsA duration 8 yrs) in the study, 56% had axial symptoms, 43% had radiographic evidence of sacroiliitis, and 13% had syndesmophytes at entry. The number of patients with neck/back pain, neck/back stiffness, and clinical sacroiliitis declined significantly at both 5- and 10-year followup periods. There was a significant increase in the number of patients with restricted cervical spinal mobility at both 5- and 10-year visits and significant reduction in lateral flexion at both timepoints. At 5 (10) years, of those without sacroiliitis at baseline, 36.6% (51.7%) developed at least grade 2 sacroiliitis; 46.5% (52.0%) of those who presented with grade 2 progressed to a higher grade; and 15.6% (25.0%) with grade 3 progressed to grade 4 sacroiliitis. Of the patients without cervical/thoracic/lumbar syndesmophytes at study entry, 11%/16%/14% (14%/21%/20%) developed syndesmophytes in these regions at 5 (10) year followup. Similar results were obtained when analyses were restricted to patients satisfying radiographic criteria alone. Conclusion. Over a 10-year period, patients with AxPsA had improvement in neck and back pain, but lateral spinal flexion and cervical mobility deteriorated.This publication has 17 references indexed in Scilit:
- The assessment of ankylosing spondylitis in clinical practiceNature Clinical Practice Rheumatology, 2007
- Efficacy and safety of adalimumab in patients with ankylosing spondylitis: Results of a multicenter, randomized, double‐blind, placebo‐controlled trialArthritis & Rheumatism, 2006
- Inflammatory back pain in ankylosing spondylitis: A reassessment of the clinical history for application as classification and diagnostic criteriaArthritis & Rheumatism, 2006
- Efficacy and safety of infliximab in patients with ankylosing spondylitis: Results of a randomized, placebo‐controlled trial (ASSERT)Arthritis & Rheumatism, 2005
- Clinically Asymptomatic Axial Disease in Psoriatic Spondyloarthropathy. A Retrospective StudyClinical Rheumatology, 2002
- Psoriatic spondyloarthropathy: a long term prospective study.Annals Of The Rheumatic Diseases, 1988
- Evaluation of Diagnostic Criteria for Ankylosing SpondylitisArthritis & Rheumatism, 1984
- Ankylosing Spondylitis and Spondylitis Accompanying Ulcerative Colitis, Regional Enteritis, Psoriasis and Reiter's Disease. A Comparative StudyArthritis & Rheumatism, 1971
- Radiological manifestations of ankylosing spondylitis according to age at onset.Annals Of The Rheumatic Diseases, 1971
- Paravertebral ossification in psoriatic arthritis.Annals Of The Rheumatic Diseases, 1965