OBJECTIVE: To evaluate changes in symptoms, spinal mobility, and radiographic features in patients with axial psoriatic arthritis (AxPsA). METHODS: Patients with AxPsA were identified from the University of Toronto Psoriatic Arthritis clinic database. Axial symptoms, metrology, and radiographic features at study entry were compared to 5-year and 10-year followup assessments. Data were analyzed using continuity adjusted McNemar's test, an exact binomial test, or logistic regression. RESULTS: Of 297 patients (mean age 42.5 yrs, PsA duration 8 yrs) in the study, 56% had axial symptoms, 43% had radiographic evidence of sacroiliitis, and 13% had syndesmophytes at entry. The number of patients with neck/back pain, neck/back stiffness, and clinical sacroiliitis declined significantly at both 5- and 10-year followup periods. There was a significant increase in the number of patients with restricted cervical spinal mobility at both 5- and 10-year visits and significant reduction in lateral flexion at both timepoints. At 5 (10) years, of those without sacroiliitis at baseline, 36.6% (51.7%) developed at least grade 2 sacroiliitis; 46.5% (52.0%) of those who presented with grade 2 progressed to a higher grade; and 15.6% (25.0%) with grade 3 progressed to grade 4 sacroiliitis. Of the patients without cervical/thoracic/lumbar syndesmophytes at study entry, 11%/16%/14% (14%/21%/20%) developed syndesmophytes in these regions at 5 (10) year followup. Similar results were obtained when analyses were restricted to patients satisfying radiographic criteria alone. CONCLUSION: Over a 10-year period, patients with AxPsA had improvement in neck and back pain, but lateral spinal flexion and cervical mobility deteriorated.
OBJECTIVE: To evaluate changes in symptoms, spinal mobility, and radiographic features in patients with axial psoriatic arthritis (AxPsA). METHODS:Patients with AxPsA were identified from the University of Toronto Psoriatic Arthritis clinic database. Axial symptoms, metrology, and radiographic features at study entry were compared to 5-year and 10-year followup assessments. Data were analyzed using continuity adjusted McNemar's test, an exact binomial test, or logistic regression. RESULTS: Of 297 patients (mean age 42.5 yrs, PsA duration 8 yrs) in the study, 56% had axial symptoms, 43% had radiographic evidence of sacroiliitis, and 13% had syndesmophytes at entry. The number of patients with neck/back pain, neck/back stiffness, and clinical sacroiliitis declined significantly at both 5- and 10-year followup periods. There was a significant increase in the number of patients with restricted cervical spinal mobility at both 5- and 10-year visits and significant reduction in lateral flexion at both timepoints. At 5 (10) years, of those without sacroiliitis at baseline, 36.6% (51.7%) developed at least grade 2 sacroiliitis; 46.5% (52.0%) of those who presented with grade 2 progressed to a higher grade; and 15.6% (25.0%) with grade 3 progressed to grade 4 sacroiliitis. Of the patients without cervical/thoracic/lumbar syndesmophytes at study entry, 11%/16%/14% (14%/21%/20%) developed syndesmophytes in these regions at 5 (10) year followup. Similar results were obtained when analyses were restricted to patients satisfying radiographic criteria alone. CONCLUSION: Over a 10-year period, patients with AxPsA had improvement in neck and back pain, but lateral spinal flexion and cervical mobility deteriorated.
Authors: Ying-ying Leung; Kwok Wah Ho; Lai Shan Tam; Tracy Y Zhu; Lai W Kwok; Tena K Li; Emily W Kun; Edmund K Li Journal: Clin Rheumatol Date: 2011-03-03 Impact factor: 2.980