Anaemia is associated with higher disease activity in axial spondyloarthritis but is not an independent predictor of spinal radiographic progression: data from the Swiss Clinical Quality Management Registry.

Micheroli, Raphael; Kissling, Seraphina; Bürki, Kristina; Möller, Burkhard; Finckh, Axel; Nissen, Michael J; Exer, Pascale; Bräm, René; Kyburz, Diego; Rubbert-Roth, Andrea; Andor, Michael; Baraliakos, Xenofon; de Hooge, Manouk; Distler, Oliver; Scherer, Almut; Ciurea, Adrian (2023). Anaemia is associated with higher disease activity in axial spondyloarthritis but is not an independent predictor of spinal radiographic progression: data from the Swiss Clinical Quality Management Registry. Clinical rheumatology, 42(9), pp. 2377-2385. Springer 10.1007/s10067-023-06662-0

[img]
Preview
Text
s10067-023-06662-0.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (1MB) | Preview

OBJECTIVE

As anaemia represents a biomarker for increased radiographic damage in rheumatoid arthritis, we aimed to investigate whether it independently predicts spinal radiographic progression in axial spondyloarthritis (axSpA).

METHODS

AxSpA patients with available haemoglobin levels from the prospective Swiss Clinical Quality Management Registry were included for comparison of patients with and without anaemia. Spinal radiographic progression was assessed according to the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) in patients with ankylosing spondylitis (AS) if ≥ 2 sets of spinal radiographs were available every 2 years. The relationship between anaemia and progression (defined as an increase ≥ 2 mSASSS units in 2 years) was analysed with generalized estimating equation models after adjustment for the Ankylosing Spondylitis Disease Activity Score (ASDAS) and potential confounding, as well as after multiple imputations of missing values.

RESULTS

A total of 212/2522 axSpA patients presented with anaemia (9%). Anaemic patients had higher clinical disease activity, higher acute phase reactants and more severe impairments in physical function, mobility and quality of life. In the subgroup of patients with AS (N = 433), a comparable mSASSS progression was found in anaemic and non-anaemic patients (OR 0.69, 95% CI 0.25 to 1.96, p = 0.49). Age, male sex, baseline radiographic damage and ASDAS were associated with enhanced progression. The results were confirmed in complete case analyses and with progression defined as the formation of ≥ 1 syndesmophyte in 2 years.

CONCLUSION

Although anaemia was associated with higher disease activity in axSpA, it did not additionally contribute to the prediction of spinal radiographic progression. Key Points • Anaemia is associated with higher disease activity and more severely impaired physical function, mobility and quality of life in axSpA. • Anaemia does not provide an additional value to ASDAS for prediction of spinal radiographic progression.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology and Immunology
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Rheumatologie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Rheumatologie

UniBE Contributor:

Möller, Burkhard

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1434-9949

Publisher:

Springer

Language:

English

Submitter:

Pubmed Import

Date Deposited:

09 Jun 2023 13:27

Last Modified:

10 Aug 2023 00:15

Publisher DOI:

10.1007/s10067-023-06662-0

PubMed ID:

37289315

Uncontrolled Keywords:

Anaemia Ankylosing spondylitis Axial spondyloarthritis Biomarker Radiographic progression

BORIS DOI:

10.48350/183268

URI:

https://boris.unibe.ch/id/eprint/183268

Actions (login required)

Edit item Edit item
Provide Feedback