Poddubnyy, DenisSieper, JoachimAkar, ServetMuñoz Fernández, SantiagoHaibel, HildrunDiekhoff, T.Protopopov, MikhailAltmaier, ElisabethGanz, FabianaInman, Robert D.2024-02-032024-02-032023Poddubnyy, D., Sieper, J., Akar, S., Muñoz‐Fernández, S., Haibel, H., Diekhoff, T., Protopopov, M., Altmaier, E., Ganz, F., & Inman, R. D. (2023). Radiographic progression in sacroiliac joints in patients with axial spondyloarthritis: Results from a five‐year international observational study. ACR Open Rheumatology, acr2.11642. https://doi.org/10.1002/acr2.116422151-464X2151-4658http://hdl.handle.net/11268/12643Objective: To evaluate progression from nonradiographic (nr-) to radiographic axial spondyloarthritis (r-axSpA) over 5 years in patients with recently diagnosed (≤1 year) axSpA fulfilling the Assessment of SpondyloArthritis international Society (ASAS) classification criteria. Methods: A prospsective, observational study (Patients with Axial Spondyloarthritis: Multi-Country Registry of Clinical Characteristics) was conducted in rheumatology practices in 29 countries. Baseline and follow-up radiographs of sacroiliac joints were centrally evaluated by three readers according to the grading system of the modified New York criteria for patients initially classified as nr-axSpA. Radiographic progression from nr-axSpA to r-axSpA was evaluated by Kaplan-Meier analysis. Cox proportional regression analyses for progression from nr-axSpA to r-axSpA were also conducted. Results: Among 2,165 patients with axSpA, 1,612 (74%) were classified as having r-axSpA (1,050 [65%]) or nr-axSpA (562 [35%]) by central reading. Of 246 patients with nr-axSpA (mean [SD] symptom duration: 4.4 [6.2] years) who had at least one follow-up sacroiliac joint radiograph, progression from nr-axSpA to r-axSpA at any follow-up visit was observed in 40 patients (16%) over 5 years. Mean time to radiographic progression was 2.4 years (ranging from 0.9 to 5.1 years). Progression to r-axSpA was associated with male sex (hazard ratio [HR] 3.16 [95% CI 1.22-8.17]), fulfillment of the imaging arm of the ASAS classification criteria (HR 6.64 [1.37-32.25]), and good response to nonsteroidal anti-inflammatory drugs (HR 4.66 [1.23-17.71]). Conclusion: 16% of patients with nr-axSpA progressed to r-axSpA within 5 years. Male sex, fulfillment of the imaging arm of the ASAS criteria, and good response to nonsteroidal anti-inflammatory drugs were predictors of radiographic progression in patients with recently diagnosed axSpA.engAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/ReumatologíaArticulacionesjournal article10.1002/acr2.11642open accessCiencias médicasPaciente