2023-06-06 15:26:07
Patients who are referred to a rheumatologist because of new, chronic back pain have a probability of around 30% to have axial spondyloarthritis. This is shown by the results of the international SPACE cohort. The diagnosis made at baseline is stable over a two-year follow-up in the vast majority of affected individuals.1
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In axial spondyloarthritis (axSpA), unacceptable diagnostic delays are the norm. On average worldwide, it takes seven years for the disease to be correctly diagnosed.2 The diagnosis of axSpA therefore takes significantly longer than the diagnosis of other rheumatic diseases, according to Dr. Mary Lucy Marques of Leiden University Medical Center. For this reason, the international multicentre longitudinal cohort SPondyloArthritis Caught Early (SPACE) was launched in 2009 with the aim of generating reliable data on the prevalence of axSpA and determining the reliability of early diagnoses in patients with chronic back pain of unknown origin.3 The results of this long-term study were presented for the first time at EULAR 2023.1
Specifically, the two-year prevalence of an axSpA diagnosis in a cohort of people who were referred to a rheumatologist because of recent chronic back pain (≥3 months, ≤2 years) was recorded. Furthermore, changes in the characteristics of subjects with or without axSpA were examined over two years.
The complete diagnostic work-up included SpA features, acute phase proteins, HLA-B27 as well as X-ray and MRI of sacroiliac joint (SI-CR and SI-MRI) and spine. Patients with a high probability of an axSpA diagnosis (at least one major or at least two minor features) were further observed, all others were excluded from the study. Main features were HLAB27, uveitis, positive family history, and sacroiliitis on X-ray or MRI. Additional features were, for example, peripheral arthritis, inflammatory back pain, psoriasis or good response to NSAIDs.
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