Clinical Relevance of Axial Radiographic Damage in Axial Spondyloarthritis: Evaluation of Functional Consequences by an Objective Electronic Device

David Kiefer; Jürgen Braun; Varvara Chatzistefanidi; Uta Kiltz; Daniela Adolf; Ilka Schwarze; Maria Kabelitz; Uwe Lange; Jan Brandt-Jürgens; Edgar Stemmler; Sabine Sartingen; Xenofon Baraliakos

doi:10.3899/jrheum.2022-1240

Clinical Relevance of Axial Radiographic Damage in Axial Spondyloarthritis: Evaluation of Functional Consequences by an Objective Electronic Device

J Rheumatol. 2023 Nov;50(11):1422-1429. doi: 10.3899/jrheum.2022-1240. Epub 2023 Apr 15.

Authors

Affiliations

¹ D. Kiefer, MD, J. Braun, MD, V. Chatzistefanidi, MD, U. Kiltz, MD, X. Baraliakos, MD, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Bochum; David.kiefer@elisabethgruppe.de.
² D. Kiefer, MD, J. Braun, MD, V. Chatzistefanidi, MD, U. Kiltz, MD, X. Baraliakos, MD, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Bochum.
³ D. Adolf, PhD, M. Kabelitz, StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH, Magdeburg.
⁴ I. Schwarze, MD, Praxis für Rheumatologie, Leipzig.
⁵ U. Lange, MD, Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen, Gießen.
⁶ J. Brandt-Jürgens, MD, Rheumatologische Schwerpunktpraxis, Berlin.
⁷ E. Stemmler, PhD, S. Sartingen, PhD, Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Wiesbaden, Germany.

PMID: 37061230
DOI: 10.3899/jrheum.2022-1240

Abstract

Objective: Axial spondyloarthritis (axSpA) is associated with decreased function and mobility of patients as a result of inflammation and radiographic damage. The Epionics SPINE device (ES), an electronic device that objectively measures spinal mobility, including range of motion (RoM) and speed (ie, range of kinematics [RoK]) of movement, has been clinically validated in axSpA. We investigated the performance of the ES relative to radiographic damage in the axial skeleton of patients with axSpA.

Methods: A total of 103 patients with axSpA, 31 with nonradiographic axSpA (nr-axSpA) and 72 with radiographic axSpA (r-axSpA), were consecutively examined. Conventional radiographs of the spine (including presence, number, and location of syndesmophytes) and the sacroiliac joints (SIJs; rated by the modified New York criteria) were analyzed with the ES. Function and mobility were assessed using analyses of covariance and Spearman correlation.

Results: The number of syndesmophytes correlated positively with Bath Ankylosing Spondylitis Metrology Index scores (r 0.38, P = 0.02) and correlated negatively with chest expansion (r -0.39, P = 0.02) and ES measurements (-0.53 ≤ r ≤ -0.34, all P < 0.03), except for RoM and RoK regarding rotation and RoK for extension of the lumbar and thoracic spines. In the radiographic evaluation of the SIJs, the extent of damage correlated negatively with ES scores and metric measurements (-0.49 ≤ r ≤ -0.33, all P < 0.001). Patients with r-axSpA, as compared to those with nr-axSpA, showed significantly worse ES scores for RoM, RoK, and chest expansion.

Conclusion: The ES scores, in accordance with mobility measurements, correlated well with the presence and extent of radiographic damage in the spine and the SIJs. As expected, patients with r-axSpA had more severe impairments than those with nr-axSpA.

Keywords: BASMI; Epionics SPINE; axial spondyloarthritis; radiographic changes; spinal measurements; spinal mobility.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Clinical Relevance
Humans
Non-Radiographic Axial Spondyloarthritis*
Sacroiliac Joint / diagnostic imaging
Spondylarthritis* / diagnostic imaging
Spondylitis, Ankylosing* / diagnostic imaging