7 year of sacroiliac radiographic progression in early psoriatic arthritis (preliminary results)

Objective – to assess the dynamics of the sacroiliac joint radiographic progression (X-SIJ) in early psoriatic arthritis (ePsA).
Methods. 32 patients (pts) (19 men and 13 women) with PsA were examined at baseline (BL) and after 7 years. Mean age – 43.9±12 years, Me PsA duration – 7.5 [6; 8.25] years, follow-up – 7 [5.75; 7.83] years. All patients received standard treatment using biologic therapy in 59.4% of cases, mainly with tumor necrosis factor α (TNF-α) inhibitors (43.7%). Radiographs of sacroiliac joint (SIJ) at BL and after 7 years were evaluated by an independent reader by Kellgren. Sacroiliitis (SI) on radiografhy (rSI) was recorded if there were changes in at least one SIJ grade II or higher. SI was considered radiologically significant (r-sSI) when it was bilateral grade II or higher, or unilateral grade III or IV. Progression was defined as the sift by ≥1 grade on any side.
Results. At BL SI was not observed in 11 (34.3%) pts, SI grade I was present in 7 (21.9%) pts, grade II – in 10 (31.3%), grade III – in 4 (12.5%). After 7 years SI was not observed in 6 (18.75%) pts, SI grade I was present in 6 (18.75%) pts, grade II – in 8 (25%), grade III – in 8 (25%), grade IV – in 4 (12.5%). At BL rSI was registered in 14 (43.75%) patients, after 7 years the number of patients with rSI increased to 20 (62.5%). At BL and 7 years follow-up r-sSI was detected in 10 (31.3%) and 16 (50%) pts (p=0.128). On each side X-SIJ progression was detected in 15 (46.9%) pts (at 1 grade – in 10, 2 grades – in 1, 3 grades – in 4), 1 patient showed a decrease at 1 grade (from III to II).
Conclusion. In ePsA radiographic progression of SI is slow. Dactylitis, high CRP, and lack of iTNF-α therapy are associated with radiographic progression.

1. Baraliakos X, Coates LC, Braun J. The involvement of the spine in psoriatic arthritis. Clin Exp Rheumatol. 2015;33(93):31-35.

2. Feld J, Ye JY, Chandran V, Inman RD, Haroon N, Cook R, et al. Axial disease in psoriatic arthritis: The presence and progression of unilateral grade 2 sacroiliitis in a psoriatic arthritis cohort. Semin Arthritis Rheum. 2021;51(2):464-468. doi: 10.1016/j.semarthrit.2021.03.007

3. Nasonov EL (ed.). Rheumatology. Russian clinical recommendations. Moscow:GEOTAR-Media;2017 (In Russ.)

4. van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum. 1984;27:361-368.

5. Chandran V, Tolusso DC, Cook RJ, Gladman DD. Risk factors for axial inflammatory arthritis in patients with psoriatic arthritis. J Rheumatol. 2010;37(4):809-815. doi: 10.3899/jrheum.091059

6. Korsakova YL, Loginova EY, Korotaeva TV, Gubar EE, Glukhova SI, Vasilenko EA, et al. The burden of progression of psoriatic arthritis. All-Russian register data. Terapevticheskii arkhiv. 2022;94(5):622-627 (In Russ.)]. doi: 10.26442/00403660.2022.05.201506

7. Gubar EE, Loginova EYu, Smirnov AV, Glukhova SI, Korotaeva TV, Nasonov EL. Clinical and instrumental characteristics of axial lesion in early peripheral psoriatic arthritis (data of a REMARCA study). Nauchno-Prakticheskaya Revmatologia = Rheumatology Science and Practice. 2018;56(1):34-40 (In Russ.) doi: 10.14412/1995-4484-2018-34-40

8. Li SS, Du N, He SH, Liang X, Li TF. Dactylitis is associated with more severe axial joint damage and higher disease activity in axial psoriatic arthritis. Rheumatol. 2022;49(9):1012-1019. doi: 10.3899/jrheum.220098

9. Protopopov M, Poddubnyy D. Radiographic progression in nonradiographic axial spondyloarthritis. Expert Rev Clin Immunol. 2018;14(6):525-533. doi: 10.1080/1744666X.2018.1477591

10. Dougados M, Sepriano A, Molto A, van Lunteren M, Ramiro S. Sacroiliac radiographic progression in recent onset axial spondyloarthritis: The 5-year data of the DESIR cohort. Ann Rheum Dis. 2017;76(11):1823-1828. doi: 10.1136/annrheumdis2017-211596

11. Fernández-Carballido C, Tornero C, Castro-Villegas MC, Galindez E, García-Llorente JF; ESPERANZA study group. No radiographic sacroiliitis progression was observed in patients with early spondyloarthritis at 6 years: Results of the Esperanza multicentric prospective cohort. RMD Open. 2020;6(2):e001345. doi: 10.1136/rmdopen-2020-001345