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

Abstract

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.