Prevalence and predictors of atlanto-axial subluxation in rheumatoid arthritis after 12-years’ follow-up (ESPOIR Cohort)
Authors' conclusion
In conclusion, the prevalence of aAAS after 12 years was 4.6% in the ESPOIR cohort, with no patients having severe aAAS.
Study context
- Population
- Patients with early polyarthritis enrolled in the ESPOIR cohort 2002–2005 (≥2 swollen joints for >6 weeks and <6 months, no other diagnosis than RA, no previous GC or DMARD exposure)followed for 12 years
- Participants
- 323 patients
- Outcome
- Prevalence of radiographic anterior atlanto-axial subluxation (anterior atlanto-dental interval ≥3 mm)
- Follow-up
- 12 years
Methodological detailsdynamic cervical-spine radiographs read by two blinded observers, univariate analysis and multiple logistic regression
- Dynamic cervical-spine radiographs read by two blinded observers
- Univariate analysis and multiple logistic regression
Main finding
As reported in the abstract
Prevalence of aAAS
Patients with aAAS
15
4.6%; 95% CI 2.8, 6.4
Severe aAAS
0
Observational data: associations, not effects.
Further findings
Baseline predictor: IgA RFs (only baseline variable associated with aAAS, P < 0.05)
- Sensitivity
- 60%
- Specificity
- 75%
10-year predictors: oral CS therapy, DMARD treatment, CRP and positive RFs associated with aAAS; only CRP and RFs remained in logistic regression model
- Sensitivity of CRP + RFs combination
- 60%
- Specificity of CRP + RFs combination
- 90%
Original publication
Prevalence and predictors of atlanto-axial subluxation in rheumatoid arthritis after 12-years’ follow-up (ESPOIR Cohort). Rheumatology (Oxford). Published 28 November 2022. doi:10.
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