Age-stratified trends in the progression of spinal radiographic damage in patients with ankylosing spondylitis: a longitudinal study

Objective: The objective of this study was to investigate spinal radiographic progression in specific age ranges of ankylosing spondylitis (AS) patients. Methods: Longitudinal data for 1125 AS patients at a single hospital from 2000 to 2018 were retrospectively reviewed. Radiographic intervals were...

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Main Authors: Tae-Han Lee, Bon San Koo, Bora Nam, Yun Jin Kim, Donghee Son, Seunghun Lee, Kyung Bin Joo, Tae-Hwan Kim
Format: Article
Language:English
Published: SAGE Publishing 2022-05-01
Series:Therapeutic Advances in Musculoskeletal Disease
Online Access:https://doi.org/10.1177/1759720X221100301
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author Tae-Han Lee
Bon San Koo
Bora Nam
Yun Jin Kim
Donghee Son
Seunghun Lee
Kyung Bin Joo
Tae-Hwan Kim
author_facet Tae-Han Lee
Bon San Koo
Bora Nam
Yun Jin Kim
Donghee Son
Seunghun Lee
Kyung Bin Joo
Tae-Hwan Kim
author_sort Tae-Han Lee
collection DOAJ
description Objective: The objective of this study was to investigate spinal radiographic progression in specific age ranges of ankylosing spondylitis (AS) patients. Methods: Longitudinal data for 1125 AS patients at a single hospital from 2000 to 2018 were retrospectively reviewed. Radiographic intervals were obtained from patients with consecutive spinal radiographs. The radiographic progression rate was defined as the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) change per year within each interval. Using generalized estimating equations (GEEs), estimated marginal means were calculated for the mSASSS progression rate across age groups after adjusting for potential confounders. Results: We obtained 4016 radiographic intervals and stratified them into five groups based on patient age at the interval start: <20 ( n  = 122); 20–29 ( n  = 1124); 30–39 ( n  = 1690); 40–49 ( n  = 794); and ⩾50 years ( n  = 286). The mean (SD) mSASSS progression rate for all the intervals was 0.8 (1.9). The GEE-estimated mean mSASSS progression rate increased with age, peaking in the 30–39 age group with a value of 1.15 [95% confidence interval (CI) 1.03, 1.27], and decreased slightly thereafter. In the presence of risk factors, rapid progression occurred at earlier ages: the GEE-estimated mean mSASSS progression rate in those with elevated C-reactive protein levels and preexisting syndesmophytes was 2.82 (95% CI 1.93, 3.71) in the 20–29 age group. Conclusion: Spinal structural damage in AS seems to progress most rapidly when patients are age 30–39 years. An awareness of the trends in radiographic progression with advancing age could improve understanding of the natural course of AS.
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spelling doaj.art-c09a9fa265d34e1b84729e6528ff58862022-12-22T02:37:46ZengSAGE PublishingTherapeutic Advances in Musculoskeletal Disease1759-72182022-05-011410.1177/1759720X221100301Age-stratified trends in the progression of spinal radiographic damage in patients with ankylosing spondylitis: a longitudinal studyTae-Han LeeBon San KooBora NamYun Jin KimDonghee SonSeunghun LeeKyung Bin JooTae-Hwan KimObjective: The objective of this study was to investigate spinal radiographic progression in specific age ranges of ankylosing spondylitis (AS) patients. Methods: Longitudinal data for 1125 AS patients at a single hospital from 2000 to 2018 were retrospectively reviewed. Radiographic intervals were obtained from patients with consecutive spinal radiographs. The radiographic progression rate was defined as the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) change per year within each interval. Using generalized estimating equations (GEEs), estimated marginal means were calculated for the mSASSS progression rate across age groups after adjusting for potential confounders. Results: We obtained 4016 radiographic intervals and stratified them into five groups based on patient age at the interval start: <20 ( n  = 122); 20–29 ( n  = 1124); 30–39 ( n  = 1690); 40–49 ( n  = 794); and ⩾50 years ( n  = 286). The mean (SD) mSASSS progression rate for all the intervals was 0.8 (1.9). The GEE-estimated mean mSASSS progression rate increased with age, peaking in the 30–39 age group with a value of 1.15 [95% confidence interval (CI) 1.03, 1.27], and decreased slightly thereafter. In the presence of risk factors, rapid progression occurred at earlier ages: the GEE-estimated mean mSASSS progression rate in those with elevated C-reactive protein levels and preexisting syndesmophytes was 2.82 (95% CI 1.93, 3.71) in the 20–29 age group. Conclusion: Spinal structural damage in AS seems to progress most rapidly when patients are age 30–39 years. An awareness of the trends in radiographic progression with advancing age could improve understanding of the natural course of AS.https://doi.org/10.1177/1759720X221100301
spellingShingle Tae-Han Lee
Bon San Koo
Bora Nam
Yun Jin Kim
Donghee Son
Seunghun Lee
Kyung Bin Joo
Tae-Hwan Kim
Age-stratified trends in the progression of spinal radiographic damage in patients with ankylosing spondylitis: a longitudinal study
Therapeutic Advances in Musculoskeletal Disease
title Age-stratified trends in the progression of spinal radiographic damage in patients with ankylosing spondylitis: a longitudinal study
title_full Age-stratified trends in the progression of spinal radiographic damage in patients with ankylosing spondylitis: a longitudinal study
title_fullStr Age-stratified trends in the progression of spinal radiographic damage in patients with ankylosing spondylitis: a longitudinal study
title_full_unstemmed Age-stratified trends in the progression of spinal radiographic damage in patients with ankylosing spondylitis: a longitudinal study
title_short Age-stratified trends in the progression of spinal radiographic damage in patients with ankylosing spondylitis: a longitudinal study
title_sort age stratified trends in the progression of spinal radiographic damage in patients with ankylosing spondylitis a longitudinal study
url https://doi.org/10.1177/1759720X221100301
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