Sacroiliac radiographic progression in recent onset axial spondyloarthritis: the 5-year data of the DESIR cohort

Ann Rheum Dis. 2017 Nov;76(11):1823-1828. doi: 10.1136/annrheumdis-2017-211596. Epub 2017 Jul 6.


Objective: To estimate sacroiliac joint radiographic (X-SIJ) progression in patients with axial spondyloarthritis (axSpA) and to evaluate the effects of inflammation on MRI (MRI-SIJ) on X-SIJ progression.

Methods: X-SIJ and MRI-SIJ at baseline and after 2 and 5 years in patients with recent onset axSpA from the DESIR cohort were scored by three central readers. Progression was defined as (1) the shift from non-radiographic (nr) to radiographic (r) sacroiliitis (by modified New York (mNY) criteria) or alternative criteria, (2) a change of at least one grade or (3) a change of at least one grade but ignoring a change from grade 0 to 1. The effects of baseline inflammation on MRI-SIJ on 5-year X-SIJ damage (mNY) were tested by generalised estimating equations.

Results: In 416 patients with pairs of baseline and 5-year X-SIJ present, net progression occurred in 5.1% (1), 13.0% (2) and 10.3% (3) respectively, regarding a shift from nr-axSpA to r-axSpA (1), a change of at least one grade (2) or a change of at least one grade but ignoring a change from grade 0 to 1 (3). Baseline MRI-SIJ predicted structural damage after 5 years in human leukocyte antigen-B27 (HLA-B27) positive (OR 5.39 (95% CI 3.25 to 8.94)) and in HLA-B27 negative (OR 2.16 (95% CI 1.04 to 4.51)) patients.

Conclusions: Five-year progression of X-SIJ damage in patients with recent onset axSpA is limited but present beyond measurement error. Baseline MRI-SIJ inflammation drives 5-year radiographic changes.

Keywords: epidemiology; magnetic resonance imaging; outcomes research; spondyloarthritis.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Cohort Studies
  • Disease Progression*
  • Female
  • France
  • HLA-B27 Antigen / analysis
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Sacroiliac Joint / diagnostic imaging*
  • Sacroiliac Joint / pathology
  • Sacroiliitis / diagnostic imaging*
  • Sacroiliitis / etiology
  • Sacroiliitis / pathology
  • Severity of Illness Index
  • Spondylarthritis / complications
  • Spondylarthritis / diagnostic imaging*
  • Spondylarthritis / pathology
  • Time Factors
  • Young Adult


  • HLA-B27 Antigen