Fatigue in early axial spondyloarthritis. Results from the French DESIR cohort.

Fatigue is frequent in long-standing axial spondyloarthritis (axSpA); its frequency in early axSpA and its causes are unclear. The objective was to evaluate the magnitude of fatigue in early axSpA and to assess if fatigue appeared more strongly associated with patient- or with disease-related characteristics. Patients were assessed in DESIR, a national observational cohort of patients with recent (<3 years duration) inflammatory back pain suggestive of axSpA. Magnitude of fatigue was assessed by a numeric rating scale (0-10) over one year. Factors associated with high fatigue (≥5/10) at 12 months were assessed by univariate and multivariate logistic regression, for patients fulfilling the ASAS axSpA criteria. Of the 708 patients, 486 fulfilled the ASAS criteria for axSpA: mean age 33±9 years; 244 (50%) males. Magnitude of fatigue was high at baseline (mean fatigue: 5.7±2.3) and decreased only slightly over the first year, and was overlapping in patients fulfilling the ASAS criteria or not. High fatigue at 12 months was well explained (variance explained: 0.84) by a higher ASDAS-CRP (odds ratio [OR]: 3.05 [95% confidence interval (CI) 2.27-4.12], P<0.0001), higher Bath Anylosing Spondylitis Patient Global (BAS-G) (OR: 3.51 [95% CI, 2.08-6.02], P<0.0001) and with borderline significance, female gender (OR: 1.65 [95% CI, 1.00-2.71], P=0.049). Fatigue levels were high in this population, both for patients fulfilling or not, the ASAS criteria for axSpA. High fatigue was closely related to disease-related variables, indicating fatigue may be an integral part of the disease process in axSpA.

Gossec L ，Dougados M ，D'Agostino MA ，Fautrel B ... -  《-》

Fatigue in Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Analysis from a Longitudinal Observation Cohort.

Bedaiwi M ，Sari I ，Thavaneswaran A ，Ayearst R ，Haroon N ，Inman RD ... -  《-》

Comparison of patients with ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA) from a single rheumatology clinic in New Delhi.

Comparison of ankylosing spondylitis (AS) with non-radiographic axial spondyloarthritis (nr-axSpA) classified with the recent ASsessment of spondyloArthritis International Society (ASAS) criteria. This study included 288 patients clinically diagnosed as having spondyloarthritis (SpA) where a satisfactory radiograph of sacroiliac (S-I) joints was available. The AS and the nr-axSpA groups were compared for the various SpA-related variables. Of 288 axSpA patients, there were 187 with AS. Of the remaining 101 patients without radiographic sacroiliitis, S-I joint magnetic resonance imaging (MRI) was available in 72; 54 of them showed active sacroiliitis thus classified as nr-axSpA according to the ASAS criteria. The remaining 18 patients with normal MRI and the other 29 patients without MRI of the S-I joints (total 47 patients), were classified as nr-axSpA using the 'clinical arm' of the ASAS criteria. On comparing the 187 AS with 101 patients in the nr-axSpA group, the AS group showed significantly more males, longer disease duration, more axial symptoms at disease onset, higher Bath Ankylosing Spondylitis Metrology Index and more syndesmophytes. Biologicals were offered significantly more often to the AS group but methotrexate as monotherapy or in combination with other disease-modifying anti-rheumatic drugs was offered more often in nr-axSpA group. There was no statistically significant difference between AS and nr-axSpA in other SpA parameters. The differences brought out between AS and nr-axSpA groups show that they may not be the same disease. A prospective long-term follow-up of large cohorts may help in clarifying if nr-axSpA is simply an early stage in the spectrum of SpA evolving into AS over time or is there inherent difference between them.

Malaviya AN ，Kalyani A ，Rawat R ，Gogia SB ... -  《-》

Clinimetric properties of the ASAS health index in a cohort of Italian patients with axial spondyloarthritis.

Di Carlo M ，Lato V ，Carotti M ，Salaffi F ... -  《Health and Quality of Life Outcomes》

Is the current ASAS expert definition of a positive family history useful in identifying axial spondyloarthritis? Results from the SPACE and DESIR cohorts.

Ez-Zaitouni Z ，Hilkens A ，Gossec L ，Berg IJ ，Landewé R ，Ramonda R ，Dougados M ，van der Heijde D ，van Gaalen F ... -  《-》