Spondyloarthritis & psoriatic arthritis
Diagnosis challenges in inception cohorts in axial spondyloarthritis: the case of the French national DESIR cohort
Authors' conclusion
These data suggest that a change in diagnosis in recent onset axSpA exists, but is not frequent, and is less likely to occur in the presence of objective features at baseline.
Study context
- Population
- Patients with recent-onset axial spondyloarthritis (axSpA) in the French national DESIR inception cohort; diagnosis based on the treating rheumatologist's opinion300 lost to follow-up
- Participants
- 708 patients
- Outcome
- Frequency of, and predisposing factors for, a change of the initial axSpA diagnosis
- Follow-up
- 10 years
Methodological detailsmulticentre, national, multiple imputation, multivariate logistic regression, Follow-up interrupted in case of a change in the initial diagnosis; currently 12.5 years of follow-up
- Multicentre
- National
- Multiple imputation
- Multivariate logistic regression
- Follow-up interrupted in case of a change in the initial diagnosis; currently 12.5 years of follow-up
Main finding
As reported in the abstract
Change in initial axSpA diagnosis · over 10 years of follow-up
Excluded due to a diagnosis change
45
6.4%
Lost to follow-up
300
42.4%
Estimated diagnosis change among those lost to follow-up (multiple imputation)
42
14.0%
Observational data: associations, not effects.
Further findings
Factors predisposing to an unchanged initial axSpA diagnosis (OR, 95% CI)
- Radiographic sacroiliitis
- 17.0 (4.1 to 71.0)
- Psoriasis
- 5.3 (2.0 to 14.3)
- CRP≥6 mg/L
- 2.7 (1.3 to 5.3)
- Good NSAID response
- 2.5 (1.5 to 4.2)
- HLA B27+
- 2.0 (1.3 to 3.3)
- Anterior chest wall pain
- 2.0 (1.2 to 3.3)
- Female sex
- 1.9 (1.2 to 3.0)
- Multivariate logistic regression on imputed data sets
Original publication
Diagnosis challenges in inception cohorts in axial spondyloarthritis: the case of the French national DESIR cohort. RMD Open. Published 23 July 2024. doi:10.
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