Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct 26;10(4):e004713.
doi: 10.1136/rmdopen-2024-004713.

Baseline and 2-year differences in spinal symptoms and spinal and hip mobility in early axial spondyloarthritis and non-axial spondyloarthritis chronic back pain patients

Ana Bento da Silva  1   2 , Sofia Ramiro  3   4 , Miranda van Lunteren  3 , Mary Lucy Marques  3   5 , Marleen van de Sande  6 , Camilla Fongen  7 , Sofia Exarchou  8 , Roberta Ramonda  9 , Désirée van der Heijde  3 , Floris A van Gaalen  3
Affiliations

Baseline and 2-year differences in spinal symptoms and spinal and hip mobility in early axial spondyloarthritis and non-axial spondyloarthritis chronic back pain patients

Ana Bento da Silva et al. RMD Open. .

Abstract

Objective: To compare spinal symptoms and spinal/hip mobility at baseline and 2 years in early axial spondyloarthritis (axSpA) and non-axSpA chronic back pain (BP) patients.

Methods: Baseline and 2 years data of the SPondyloarthritis Caught Early cohort were analysed. Outcomes assessed: overall BP, BP at night, morning stiffness (MS) intensity, MS duration, occiput-to-wall distance (OWD), cervical rotation, chest expansion, lateral spinal flexion (LSF), modified Schober test (mSchober), intermalleolar distance (IMD) and Bath Ankylosing Spondylitis Metrology Index (BASMI). Linear or zero-inflated negative binomial regression was used to compare 2 years outcomes between groups (adjusting for baseline value, sex, age and use of non-steroidal anti-inflammatory drugs).

Results: There were 294 axSpA and 123 non-axSpA patients (mean symptom duration: 13 months). At baseline, non-axSpA patients had worse symptoms and mobility, except OWD (eg, mean(SD): BP at night 3.6 (2.9) axSpA vs 4.6 (2.7) non-axSpA; OWD 0.5 (1.2) vs 0.1 (0.7)). After 2 years, all symptoms and cervical rotation significantly improved in both groups, but LSF and mSchober only in axSpA. In multivariable analyses, axSpA was associated with larger improvements in BP at night (β (95% CI): -0.85 (-1.47; -0.23)), mSchober (0.26 (0.03; 0.50)), IMD (4.86 (1.93; 7.80)) and BASMI (-0.24 (-0.41; -0.08)), and with lower likelihood of a normal OWD (OR (95% CI): 0.09 (0.01; 0.83)).

Conclusion: Over 2 years, all spinal symptoms and some mobility measures improved in both groups, but impairments remained prevalent (particularly in non-axSpA). Nevertheless, axSpA was associated with larger improvements in BP at night, mSchober, IMD and BASMI, but with more OWD impairment.

Keywords: Axial Spondyloarthritis; Low Back Pain; Patient Reported Outcome Measures.

PubMed Disclaimer

Conflict of interest statement

Competing interests: SR has received research grants and/or consultancy fees from AbbVie, Eli Lilly, Galapagos, Janssen, MSD, Novartis, Pfizer, UCB and Sanofi. MvdS has acknowledged speakers fees from Janssen, Novartis, UCB and Beneke, consulting fees from Janssen, Novartis, Abbvie and UCB, and research support from Janssen, Novartis and UCB. SE has received consulting fees from Amgen, Janssen, Novartis, AbbVie and UCB. RR has received consulting and/or speaking fees from Advisory Boards from Abbvie, Novartis, Janssen, Lilly, MSD, Pfizer and UCB. DvdH has acknowledge consulting fees from AbbVie, Argenx, BMS, Galapagos, Glaxo-Smith-Kline, Janssen, Lilly, Novartis, Pfizer, Takeda and UCB; associate editor Annals Rheumatic Diseases, editorial board member Journal of Rheumatology and RMD Open, Advisor Assessment Axial Spondyloarthritis international Society and director of Imaging Rheumatology bv. FAvG has received grants/research supports from Stichting ASAS, Novartis and UCB, and received honoraria or consultation fees from Novartis, BMS, AbbVie, MSD, Janssen, Lily and UCB. The remaining authors have declared no conflicts of interest.

Figures

Figure 1
Figure 1. Impact of axSpA versus non-axSpA on 2 years back pain and morning stiffness.#
#Linear regression models, adjusted for the baseline value of the respective outcome, sex, age and use of NSAIDs. *p<0.05. axSpA, axial spondyloarthritis; NSAIDs, non-steroidal anti-inflammatory drugs.
Figure 2
Figure 2. Impact of axSpA versus non-axSpA on 2 years spinal and hip mobility measures.#
#Linear regression models, adjusted for the baseline value of the respective outcome, sex, age and use of NSAIDs. For occiput-to-wall distance, a zero-inflated negative binomial (ZINB) model was built instead. ZINB generates two different models: a logit model and a negative binomial model. The logit model reflects the odds of being a ‘certain zero’ and the negative binomial model (not shown) predicts the score of those not in the ‘certain zero’ group. *p<0.05 axSpA, axial spondyloarthritis; BASMI, Bath Ankylosing Spondylitis Metrology Index; NSAIDs, non-steroidal anti-inflammatory drugs.
See this image and copyright information in PMC

References

    1. Navarro-Compán V, Sepriano A, El-Zorkany B, et al. Axial spondyloarthritis. Ann Rheum Dis. 2021;80:1511–21. doi: 10.1136/annrheumdis-2021-221035. - DOI - PubMed
    1. Ward MM. Health-related quality of life in ankylosing spondylitis: A survey of 175 patients. Arthritis & Rheum. 1999;12:247–55. doi: 10.1002/1529-0131(199908)12:4<247::AID-ART3>3.0.CO;2-H. - DOI - PubMed
    1. Kiltz U, Baraliakos X, Regel A, et al. Causes of pain in patients with axial spondyloarthritis. Clin Exp Rheumatol. 2017;35 Suppl 107:102–7. - PubMed
    1. Braun J, Baraliakos X, Kiltz U. Treat-to-target in axial spondyloarthritis - what about physical function and activity? Nat Rev Rheumatol. 2021;17:565–76. doi: 10.1038/s41584-021-00656-5. - DOI - PubMed
    1. Machado P, Landewé R, Braun J, et al. Both structural damage and inflammation of the spine contribute to impairment of spinal mobility in patients with ankylosing spondylitis. Ann Rheum Dis. 2010;69:1465–70. doi: 10.1136/ard.2009.124206. - DOI - PubMed