Spondyloarthritis & psoriatic arthritis
Atlantoaxial Subluxation in Patients With Psoriatic Arthritis
Authors' conclusion
AAS is an uncommon complication in PsA strongly associated with radiographic sacroiliitis and radiographic damage in peripheral joints.
Study context
- Population
- Observational cohort of patients with psoriatic arthritis (PsA), excluding history of trauma or cervical spine surgery
- Participants
- 1,535 participants
- Exposure
- PsA patients with vs without AAS
- AASn = 34
- Outcome
- Prevalence and incidence of AAS in PsA
Methodological detailsCox regression with time-varying covariates, multivariable generalized estimating equations (GEE) analysis
- Cox regression with time-varying covariates
- Multivariable GEE analysis
Main finding
As reported in the abstract
AAS prevalence and incidence
| Group | Value | Incidence |
|---|---|---|
| AAS | 2.21% | 1.16 per 1000 person-years |
AAS
Value2.21%
Incidence1.16 per 1000 person-years
- AAS at baseline
- 20
- AAS during follow-up
- 14
Observational data: associations, not effects.
Further findings
Predictors of AAS development (Cox regression)
| HR (95% CI) | ||
|---|---|---|
| Radiographic sacroiliitisStrongest predictor | 6.61 (1.64–26.67) | |
| Male sex | 0.25 (0.07–0.89) | |
| 0.050.21520Hazard ratio (log scale) |
Associations with AAS (GEE)
| OR (95% CI) | ||
|---|---|---|
| Radiographic sacroiliitis | 3.64 (1.61–8.24) | |
| Higher modified Steinbrocker score | 1.01 (1.00–1.02) | |
| Older age | 0.95 (0.92–0.98) | |
| Male sex | 0.40 (0.17–0.92) | |
| 0.10.31310Odds ratio (log scale) |
Characteristics of patients with AAS
- Radiographic sacroiliitis in AAS
- 64.71%
- Elevated erythrocyte sedimentation rate (ESR) in AAS cases
- 84.85%
- Greater peripheral joint damage in AAS
Original publication
Atlantoaxial Subluxation in Patients With Psoriatic Arthritis. J Rheumatol. Published 1 November 2025. doi:10.
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